Individual
DR. CAROLYN SUE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
4925 BRADENTON AVE, SUITE A, DUBLIN, OH 43017-7532
(614) 792-1974
(614) 760-1996
Mailing address
4925 BRADENTON AVE, SUITE A, DUBLIN, OH 43017-7532
(614) 792-1974
(614) 760-1996
Taxonomy
Speciality
Code
Description
License number
State
152WV0400X
Vision Therapy Optometrist
Primary
4089
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0762509
—
OH
Enumeration date
12/15/2006
Last updated
05/18/2018
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