Individual
DR. CLARK ALLEN JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3101 WYOMING BLVD SW, CASPER, WY 82604-4543
(307) 265-7008
(307) 234-9405
Mailing address
3101 WYOMING BLVD SW, CASPER, WY 82604-4543
(307) 265-7008
(307) 234-9405
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
166T
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0803620001
—
WY
Enumeration date
11/22/2005
Last updated
09/14/2007
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