Individual
JEFFREY JAY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
43927 15TH ST W, LANCASTER, CA 93534-4758
(661) 948-6310
Mailing address
43927 15TH ST W, LANCASTER, CA 93534-4758
(661) 948-6310
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
13495
CA
Other
Enumeration date
07/03/2008
Last updated
07/03/2008
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