Individual
TERRI S CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
406 HIGHWAY 6 SOUTH, OAKLAND, IA 51560-0323
(712) 482-3686
(712) 482-3636
Mailing address
406 HIGHWAY 6 SOUTH, OAKLAND, IA 51560-0323
(712) 482-3686
(712) 482-3636
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0432617
—
IA
Enumeration date
11/02/2006
Last updated
07/08/2007
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