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General NPI Number Information
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NPI Number | 1861669962
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Entity Type | Organization
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Legal Business Name | CLARK C. BYROAD D.C., P.A.
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Dates
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Enumeration Date | 05/08/2008
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Last Update Date | 05/08/2008
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Provider Practice Location Address
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Address Line | 575 N VALLEY PKWY SUITE 100
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City | LEWISVILLE
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State | TX
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Zip | 75067-3437
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Country | US
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Telephone | 972-219-0434
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Fax |
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Provider Business Mailing Address
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Address Line | 575 N VALLEY PKWY SUITE 100
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City | LEWISVILLE
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State | TX
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Zip | 75067-3437
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Country | US
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Telephone | 972-219-0434
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CLARK CLAIRE BYROAD
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Credential | DC
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Telephone | 972-219-0434
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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 |
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License Number State |
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