Clark, Ronald Frederick

Clark, Ronald Frederick is an individual health care provider with primary practice located at 5 Newington Road , West Hartford CT 06110-2310. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Clark, Ronald Frederick can be contacted via phone (860) 236-3364.

Contact Information

Primary practice address
5 Newington Road West Hartford CT 06110-2310
Phone: (860) 236-3364
Fax: (860) 236-3364
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 000210 Connecticut

Profile Details

NPI number 1588762801
LBN Legal business name Clark, Ronald Frederick
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 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 1588762801 NPPES
Connecticut MEDICAID 04046611
Connecticut Other 050000210CT01

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