Clark, Deirdre V

Clark, Deirdre V is an sole proprietor health care provider with primary practice located at 10926 David Taylor Dr Ste 120 , Charlotte NC 28262-1042. She recently has 5 registered licenses in different health care specialties including Chiropractic Providers / Independent Medical Examiner, Other Service Providers / Case Manager/Care Coordinator, Other Service Providers / Research Study, Other Service Providers / Naturopath, Chiropractic Providers / Chiropractor. Chiropractic Providers / Chiropractor is her primary health care specialty. Clark, Deirdre V can be contacted via phone (704) 266-3250.

Contact Information

Primary practice address
10926 David Taylor Dr Ste 120 Charlotte NC 28262-1042
Phone: (704) 266-3250
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Independent Medical Examiner 111NI0013X 5172 North Carolina
Chiropractic Providers / Independent Medical Examiner 111NI0013X 5171 North Carolina
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Other Service Providers / Research Study 1744R1102X
Other Service Providers / Naturopath 175F00000X
Chiropractic Providers / Chiropractor 111N00000X 5172 North Carolina

Profile Details

NPI number 1053615989
LBN Legal business name Clark, Deirdre V
Credentials DC, ND, CHT, CCRA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 6th, 2011
Last updated Aug 27th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053615989 NPPES
North Carolina Other 5172 CHIROPRACTIC LICENSE

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