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General NPI Number Information
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NPI Number | 1013043645
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Entity Type | Individual
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Provider Name | THOMAS CLARK OLIVER D.C.
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Gender | Male
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 3020 PACIFIC AVE
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City | STOCKTON
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State | CA
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Zip | 95204-4919
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Country | US
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Telephone | 209-466-1234
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Fax | 209-466-6181
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Provider Business Mailing Address
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Address Line | 3020 PACIFIC AVE
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City | STOCKTON
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State | CA
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Zip | 95204-3639
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Country | US
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Telephone | 209-466-1234
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Fax | 209-466-6181
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC26463
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License Number State | CA
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