Clark, Anna J

Clark, Anna J is an sole proprietor health care provider with primary practice located at 4491 Bent Brothers Blvd. , Colorado City CO 81019-9366. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Clark, Anna J can be contacted via phone (719) 676-3937.

Contact Information

Primary practice address
4491 Bent Brothers Blvd. Colorado City CO 81019-9366
Phone: (719) 676-3937
Fax: (719) 676-4390
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2855 Colorado

Profile Details

NPI number 1376831693
LBN Legal business name Clark, Anna J
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 20th, 2011
Last updated Dec 20th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376831693 NPPES
Colorado MEDICAID 00685232

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