Individual
NICHOLAS L CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2185 NW 2ND ST, MCMINNVILLE, OR 97128-9108
(503) 435-1231
(503) 435-0151
Mailing address
2185 NW 2ND ST, MCMINNVILLE, OR 97128-9108
(503) 435-1231
(503) 435-0151
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3319 ATI
OR
Other
Enumeration date
11/25/2009
Last updated
07/29/2015
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