Jack J. Clark, D.C.P.C. in Fort Wayne - Rehabilitation
Jack J. Clark, D.C.P.C. - NPI 1083820302
Jack J. Clark, D.C.P.C. is a Rehabilitation in Fort Wayne, Indiana. Jack J. Clark, D.C.P.C. practices all healthcare services and medical treatments related to Rehabilitation. The NPI Number for Jack J. Clark, D.C.P.C. is 1083820302. The last update date is 2008-06-27.
Jack J. Clark, D.C.P.C.'s current location address is 6015 E State Blvd, Fort Wayne, Indiana. You can contact this provider via phone number 2604861886 and fax number 2604853958. The mailing address for Jack J. Clark, D.C.P.C. is 6015 E State Blvd, Fort Wayne, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Jack J. Clark, D.C.P.C. |
|---|---|
| Address | 6015 E State Blvd, Fort Wayne, Indiana |
| Phone Number | 2604861886 |
| Fax Number | 2604853958 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OFFICE MAN |
|---|---|
| Authorized Official Name | Badiac Valerie |
| Telephone Number | 2604861886 |
NPI Number Detail
| NPI Number | 1083820302 |
|---|---|
| Provider Enumeration Date | 2007-05-15 |
| Last Updated Date | 2008-06-27 |
Provider Mailing Address Detail
| Address | 6015 E State Blvd |
|---|---|
| City | Fort Wayne |
| State | Indiana (IN) |
| Post Code | 468157638 |
| Phone Number | 2604861886 |
| Fax Number | 2604853958 |
Provider's Primary Taxonomy Detail
| Speciality | Rehabilitation |
|---|---|
| Taxonomy | 111Nr0400X |
| Licence No | 08002245A |
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Definition: Rehabilitation is the discipline focused on restoring a patient's functional abilities to pre-injury or pre-disease status. Functional abilities are defined as those activities in one's daily life, work, or sports and recreational activities that an |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 100289660A | IN | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Jack J. Clark, D.C.P.C. by the Centers for Medicare & Medicaid Services?
The Jack J. Clark, D.C.P.C. has been issued the NPI (National Provider Identifier) 1083820302, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Jack J. Clark, D.C.P.C. is physically located?
The Jack J. Clark, D.C.P.C. is situated at the following address: 6015 E State Blvd, Fort Wayne, IN 468157638.
What is Jack J. Clark, D.C.P.C.'s primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Jack J. Clark, D.C.P.C. is Rehabilitation, and the corresponding taxonomy classification code for this specialized field is 111Nr0400X.
When did the Jack J. Clark, D.C.P.C. receive its 1083820302?
The Jack J. Clark, D.C.P.C. was issued its 1083820302 on 2007-05-15, which is the date when the organization was assigned this unique identifier.
As of what date were the Jack J. Clark, D.C.P.C.'s details last updated?
The information pertaining to the Jack J. Clark, D.C.P.C., including its address, specialty, and other details, was most recently updated on 2008-06-27.