Provider Demographics
NPI:1235465030
Name:CLARKE, ROY MARTIN (DC)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:MARTIN
Last Name:CLARKE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 E ALTAMONTE DR
Mailing Address - Street 2:STE 2250
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-4652
Mailing Address - Country:US
Mailing Address - Phone:407-654-2575
Mailing Address - Fax:407-654-6027
Practice Address - Street 1:10882 W COLONIAL DR
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-2981
Practice Address - Country:US
Practice Address - Phone:407-654-2575
Practice Address - Fax:407-654-6027
Is Sole Proprietor?:No
Enumeration Date:2009-10-29
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH-9831111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor