| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JACKSON DALE CLEMENTS | 1376249516 | 2023-02-11 |
Jackson Dale Clements is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1376249516. Registration indicates Jackson Dale Clements is a provider of services with a specialization in Chiropractic Providers, Chiropractor (Chiropractor, ) (Speech/Occupational/Physical Therapy/Chiropractor, ) (Chiropractor, Chiropractic Providers)
| Entity Type | Individual |
| Provider Name | Dr. Jackson Dale Clements DC |
| Practice Office Address | 12631 ANTIOCH RD OVERLAND PARK, KS US |
| Practice Office Telephone | 9136850022 |
| Mailing Address | 14751 OUTLOOK ST OVERLAND PARK, KS 662231182 US |
| Business Telephone | 9135686287 |
| Code | Practice | License No State |
|---|---|---|
| 111N00000X PRIMARY | Chiropractic Providers Chiropractor Chiropractor Speech/Occupational/Physical Therapy/Chiropractor Chiropractor Chiropractic Providers | 01-06246
KS |