Provider Demographics
NPI:1649493255
Name:CLARK, LORI KARIN (DC)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:KARIN
Last Name:CLARK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 MILLWRIGHT DR
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-1256
Mailing Address - Country:US
Mailing Address - Phone:609-502-8034
Mailing Address - Fax:
Practice Address - Street 1:162 BLUFFTON RD
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-6340
Practice Address - Country:US
Practice Address - Phone:843-706-3472
Practice Address - Fax:843-706-3473
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC04026111N00000X
SC4119111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor