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General NPI Number Information
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NPI Number | 1396018040
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Entity Type | Organization
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Legal Business Name | CLARKE CHIROPRACTIC AND REHABILITATION
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Dates
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Enumeration Date | 02/10/2012
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Last Update Date | 10/29/2014
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Provider Practice Location Address
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Address Line | 4000 N STATE ROAD 7 SUITE 409
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33319-4804
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Country | US
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Telephone | 954-769-0790
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Fax | 954-530-7267
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Provider Business Mailing Address
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Address Line | 4000 N STATE ROAD 7 SUITE 409
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33319-4804
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Country | US
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Telephone | 954-769-0790
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Fax | 954-530-7267
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHEREFFA CLARKE
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Credential | D.C.
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Telephone | 954-769-0790
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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 | CH10510
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License Number State | FL
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