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Individual

DR. CHRISTINE D CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D., TVI, DTV

Contact information

Practice address
221 WOODLAND AVE, BLOOMINGTON, IL 61701-5659
(309) 824-5841
Mailing address
221 WOODLAND AVE, BLOOMINGTON, IL 61701-5659
(309) 824-5841

Taxonomy

Speciality
Code
Description
License number
State
152WV0400X
Vision Therapy Optometrist
Primary
NON NUMBERED LICENSE
UT

Other

Enumeration date
01/08/2008
Last updated
01/08/2008
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