Healthcare Provider Details

I. General information

NPI: 1124946728
Provider Name (Legal Business Name): LUCIA CLARKE DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1739 ELM CT STE 101
JEFFERSON CITY MO
65101-4303
US

IV. Provider business mailing address

3237 W TRUMAN BLVD STE 100
JEFFERSON CITY MO
65109-6944
US

V. Phone/Fax

Practice location:
  • Phone: 573-635-4747
  • Fax: 573-635-6722
Mailing address:
  • Phone: 573-635-4827
  • Fax: 573-635-4361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2026031733
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: