DR. Chad Clark, O.D.

NPI #1205241577 in Boise, Idaho

Provider Information

NPI Number: 1205241577
Entity Type: Individual
Name: DR. Chad Clark, O.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Optometrist
Credential: O.D.
Enumeration Date: Jun 25, 2014
Last Updated: Nov 14, 2022

Practice Location

Address: 1205 S FIVE MILE RD
City: Boise
State: Idaho
ZIP Code: 83709-1304
Phone: (208) 322-8381

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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