Individual
DR. TODD MATHEW CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
395 N WEST ST, SUITE B, WESTERVILLE, OH 43082-1400
(614) 839-2733
(614) 839-5367
Mailing address
395 N WEST ST, SUITE B, WESTERVILLE, OH 43082-1400
(614) 839-2733
(614) 839-5367
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4992
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1309550001
NATIONAL GOVERNMENT SERVICES - DMERC
OH
Enumeration date
03/19/2007
Last updated
12/07/2011
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