Clark, Travis
Clark, Travis is an sole proprietor health care provider with primary practice located at 510 E North Broadway St , Columbus OH 43214-4114. He recently has only one registered license in Speech, Language and Hearing Service Providers / Hearing Instrument Specialist, which is considered as his primary health care specialty. Clark, Travis can be contacted via phone (614) 263-5151.Contact Information
Primary practice address
510 E North Broadway St
Columbus OH 43214-4114
Phone: (614) 263-5151
Fax: (614) 263-5365
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Hearing Instrument Specialist | 237700000X | IL02725 | Ohio |
Profile Details
| NPI number | 1861765398 |
|---|---|
| LBN Legal business name | Clark, Travis |
| Credentials | HAS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 14th, 2012 |
| Last updated | Dec 24th, 2019 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861765398 | NPPES |
| Ohio | Other | IL02725 | STATE LICENSE |
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