Clark, Michael
Clark, Michael is an individual health care provider with primary practice located at 990 Medical Dr Ste G3 , Brigham City UT 84302. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Clark, Michael can be contacted via phone (435) 374-2097.Contact Information
Primary practice address
990 Medical Dr Ste G3
Brigham City UT 84302
Phone: (435) 374-2097
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 10841920-9934 | Utah |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 10841920-9934 | Utah |
Profile Details
| NPI number | 1558858464 |
|---|---|
| LBN Legal business name | Clark, Michael |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 16th, 2018 |
| Last updated | Jun 4th, 2018 - about 6 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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