Individual provider · NPI-1

Dr. Carolyn Sue Clark, O.D.

Optometrist, Vision Therapy · Dublin, OH

NPI number1013079771
StatusActive
Last updated in NPPESMay 18, 2018

Details

NPI
1013079771
Entity type
Individual (NPI-1)
Name
Dr. Carolyn Sue Clark
Credential
O.D.
Sex
Female
Sole proprietor
Yes
Enumeration date
Dec 15, 2006
Last updated
May 18, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152WV0400X Optometrist, Vision Therapy4089OHYes

Practice location

4925 Bradenton Ave
Suite A
Dublin, OH 43017-7532

Phone 614-792-1974 · Fax 614-760-1996

Mailing address

4925 Bradenton Ave
Suite A
Dublin, OH 43017-7532

Phone 614-792-1974 · Fax 614-760-1996

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