Gregory Clark, O.d., Inc.
NPI #1801965504 in Coon Rapids, Minnesota
Provider Information
- NPI Number
- 1801965504
- Entity Type
- Organization
- Organization Name
- Gregory Clark, O.d., Inc.
- Primary Specialty
- Optometrist
- Enumeration Date
- Nov 7, 2006
- Last Updated
- Nov 29, 2012
Practice Location
- Address
- 12547 RIVERDALE BLVD NW
- Address 2
- COSTCO OPTICAL DEPARTMENT
- City
- Coon Rapids
- State
- Minnesota
- ZIP Code
- 55448-6708
- Phone
- (763) 712-7761
Authorized Official
- Name
- DR. GREGORY ALEXANDER CLARK, O.D.
- Title
- OWNER
- Phone
- (612) 703-0298
Specialties & Taxonomy Codes
| Specialty |
|---|
| Optometrist |
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