Provider Demographics
NPI:1275605495
Name:CLARKE, REBECCA ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:ANN
Last Name:CLARKE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8595 PELHAM RD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-5759
Mailing Address - Country:US
Mailing Address - Phone:864-286-8388
Mailing Address - Fax:864-286-8398
Practice Address - Street 1:8595 PELHAM RD
Practice Address - Street 2:SUITE 600
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-5759
Practice Address - Country:US
Practice Address - Phone:864-286-8388
Practice Address - Fax:864-286-8398
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2836111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor