Clark, Christopher Russell

Clark, Christopher Russell is an sole proprietor health care provider with primary practice located at 177 E High St , Waynesburg PA 15370-1818. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Clark, Christopher Russell can be contacted via phone (724) 852-1777.

Contact Information

Primary practice address
177 E High St Waynesburg PA 15370-1818
Phone: (724) 852-1777
Fax: (724) 852-1777
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X DC007628L Pennsylvania

Profile Details

NPI number 1134175474
LBN Legal business name Clark, Christopher Russell
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 26th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134175474 NPPES
Pennsylvania Other 01666127 GROUP HIGHMARK BCBS
Pennsylvania MEDICAID 1010082300001 GROUP HIGHMARK BCBS
Pennsylvania Other 897504 GROUP HIGHMARK BCBS
Pennsylvania Other 1134175474 GROUP HIGHMARK BCBS

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