Clark, Thomas Edward
Clark, Thomas Edward is an individual health care provider with primary practice located at 3672 W South Jordan Pkwy Ste 103 , South Jordan UT 84009-7172. He recently has 4 registered licenses in different health care specialties including Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Sports Vision, Eye and Vision Services Providers / Vision Therapy, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Clark, Thomas Edward can be contacted via phone (801) 810-1060.Contact Information
Primary practice address
3672 W South Jordan Pkwy Ste 103
South Jordan UT 84009-7172
Phone: (801) 810-1060
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Eye and Vision Services Providers / Pediatrics | 152WP0200X | 11777686-9934 | Utah |
Eye and Vision Services Providers / Sports Vision | 152WS0006X | 11777686-9934 | Utah |
Eye and Vision Services Providers / Vision Therapy | 152WV0400X | 11777686-9934 | Utah |
Eye and Vision Services Providers / Optometrist | 152W00000X | 11777686-9934 | Utah |
Profile Details
NPI number | 1669096020 |
---|---|
LBN Legal business name | Clark, Thomas Edward |
Credentials | Doctor of Optometry (OD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 2nd, 2020 |
Last updated | Jun 2nd, 2020 - about 4 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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