Theodore Jeffrey Clark, D.C.

NPI #1861705964 in Renton, Washington

Provider Information

NPI Number: 1861705964
Entity Type: Individual
Name: Theodore Jeffrey Clark, D.C.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Chiropractor
Credential: D.C.
Enumeration Date: Jul 17, 2010
Last Updated: Jul 17, 2010

Practice Location

Address: 17422 108TH AVE SE
Address 2: #101
City: Renton
State: Washington
ZIP Code: 98055-5400
Phone: (425) 255-0427

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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