Clark, Tina L

Clark, Tina L is an individual health care provider with primary practice located at 557 Highway 11 , Monroe GA 30655-6078. She recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as her primary health care specialty. Clark, Tina L can be contacted via phone (678) 758-4783.

Contact Information

Primary practice address
557 Highway 11 Monroe GA 30655-6078
Phone: (678) 758-4783
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optician 156FX1800X LDO2206 Georgia

Profile Details

NPI number 1902664022
LBN Legal business name Clark, Tina L
Credentials LDO2206
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 12th, 2024
Last updated Mar 19th, 2024 - about last year

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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