Individual
JAMIE L CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ABOC, NCLEC
Contact information
Practice address
254 CASSIDY BLVD, PIKEVILLE, KY 41501-1426
(606) 432-0838
(606) 432-7658
Mailing address
254 CASSIDY BLVD, PIKEVILLE, KY 41501-1426
(606) 432-0238
(606) 432-7658
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
277978
KY
Other
Enumeration date
06/15/2022
Last updated
03/14/2023
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