OrganizationClyde Park Chiropractic, P.C.ChiropractorChiropractic ProvidersPractice Address4315 Clyde Park Ave SW, Wyoming, MI 49509-4101(616) 532-4500PECOS EnrollmentBased on the most recent information from CMS, provider Clyde Park Chiropractic, P.C. does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 4:18 PM.Profile DetailsProvider ID1811140858Provider TypeOrganizationFull NameClyde Park Chiropractic, P.C.SubpartNoEnumeration Date11/3/2008Last Updated11/3/2008Contact InformationPractice LocationPractice Address4315 Clyde Park Ave SW, Wyoming, MI 49509-4101Phone(616) 532-4500Fax(616) 532-7344Mailing LocationMailing Address4315 Clyde Park Ave SW, Wyoming, MI 49509-4101Phone(616) 532-4500Fax(616) 532-7344Authorized OfficialNameGladish, Mary E. (President)Phone(616) 532-4500Provider TaxonomiesCodeDescriptionLicenseCode111N00000XPrimaryDescriptionChiropractorChiropractic ProvidersLicense2301008725Michigan