Organization
CLARKSON OPTOMETRY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA HOLT (MANAGER OF CENTRAL OPERATIONS)
(636) 200-4393
Entity
Organization
Contact information
Practice address
40 E NORTH ST, EUREKA, MO 63025
(636) 200-4393
(636) 938-2650
Mailing address
PO BOX 207158, DALLAS, TX 75320-7158
(636) 200-4393
(636) 527-0766
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
502027709
—
MO
01
—
CE9167
RAILROAD MEDICARE
MO
Enumeration date
05/17/2006
Last updated
07/05/2019
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