Individual
MS. CAROL ANN CLARKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
9836 US HIGHWAY 301 S, RIVERVIEW, FL 33569-5829
(813) 677-2995
(813) 677-5549
Mailing address
9836 US HIGHWAY 301 S, RIVERVIEW, FL 33569-5829
(813) 677-2995
(813) 677-5549
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
3147
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
630055300
—
FL
Enumeration date
08/24/2006
Last updated
06/15/2010
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