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Dr. Jack J Clark, DC
Chiropractor in Fort Wayne, Indiana
NPI 1902881014

Jack J Clark is a Chiropractor based in Fort Wayne, IN. Jack J Clark practices in Fort Wayne, IN and has the professional credentials of DC. The NPI Number for Jack J Clark is 1902881014 and holds a License No. 08000717A (Indiana).

The current practice location address for Jack J Clark is 6015 E State Blvd, Fort Wayne, IN and can be reached out via phone at 260-486-1886.

Location: 6015 E State Blvd, Fort Wayne, IN, 46815-7638
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Provider Profile Details
NPI Number
1902881014
Provider Name
Jack J Clark
Credential
DC
Provider Entity Type
Individual
Gender
Male
Address
6015 E State Blvd, Fort Wayne, IN, 46815-7638
Phone Number
260-486-1886
Fax Number
Provider Enumeration Date
12/12/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100289660A 05 IN
000000086699 01 IN BLUE CROSS/BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
6015 E State Blvd
City
State
Zip
46815-7638
Phone Number
260-486-1886
Fax Number
person
Provider Business Mailing Address Details
Address
6015 E State Blvd
City
State
Zip
46815-7638
Phone Number
260-486-1886
Fax Number
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
License No.
08000717A (Indiana)
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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