Provider Demographics
NPI:1922562230
Name:CLARE, EMILIE E (DC)
Entity type:Individual
Prefix:DR
First Name:EMILIE
Middle Name:E
Last Name:CLARE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:EMILIE
Other - Middle Name:ELIZABETH CLARE
Other - Last Name:MCDONALD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1 DEBRA CIR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:KS
Mailing Address - Zip Code:67010-9438
Mailing Address - Country:US
Mailing Address - Phone:316-350-7515
Mailing Address - Fax:
Practice Address - Street 1:415 STATE ST STE 106
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:KS
Practice Address - Zip Code:67010-1105
Practice Address - Country:US
Practice Address - Phone:316-350-7515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-31
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-06120111N00000X
TX14018111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS01-06120OtherKANSAS BOARD OF HEALING ARTS
TX14018OtherTEXAS BOARD OF CHIROPRACTIC