Tessa J Clark, OD
Optometrist in Mt Pleasant, SC. Individual provider (NPI-1).
NPI number1376112797
StatusActive
Last updated in NPPESMar 7, 2022
Details
- NPI
- 1376112797
- Entity type
- Individual (NPI-1)
- Name
- Tessa J Clark
- Credential
- OD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 21, 2021
- Certification date
- Mar 7, 2022
- Last updated
- Mar 7, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 2280 | SC | Yes |
Practice location
1101 Clarity Rd Ste 100Mt Pleasant, SC 29464-3138
Phone 843-881-3937 · Fax 843-375-1487
Mailing address
2861 Tricom StNorth Charleston, SC 29406-9172
Phone 843-725-0064 · Fax 843-569-7885
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