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NPI Code Detail

MEDICARE: DR. AUSTIN FREDERICK CLARKE I DC

MEDICARE:  DR. AUSTIN FREDERICK CLARKE I DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorCHR.0008401CO

General Provider Information

NPI Number : 1689243552
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AUSTIN FREDERICK CLARKE I DC
Provider Business Mailing Address
First Line : 1935 E BIJOU ST
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-5816
Country : US
Telephone Number : 719-475-8877
Fax Number :
Provider Business Practice Location Address
First Line : 1935 E BIJOU ST
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-5816
Country : US
Telephone Number : 719-475-8877
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2021
Last Update Date : 06/23/2021

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Directions to “ DR. AUSTIN FREDERICK CLARKE I DC” Practice Location

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