Organization
LINDA J. CLARK, O.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LINDA J. CLARK O.D. (OWNER)
(574) 533-4910
Entity
Organization
Contact information
Practice address
1765 STAFFORD CT, GOSHEN, IN 46526-6542
(574) 533-4910
(574) 534-3479
Mailing address
1765 STAFFORD CT, GOSHEN, IN 46526-6542
(574) 533-4910
(574) 534-3479
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002119
IN
Other
Enumeration date
06/18/2009
Last updated
06/18/2009
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