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1205241577
CHAD CLARK
BOISE, ID
NPI
1205241577
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
152W00000X Optometrist
(Licence: ID ODP-100308)
Enumeration Date
2014-06-25
Last Update Date
2022-11-14
Business Address
Dr. CHAD CLARK O.D.
1205 S FIVE MILE RD
BOISE, ID 83709-1304
Phone number: 208-322-8381
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Mailing Address
Dr. CHAD CLARK O.D.
1205 S FIVE MILE RD
BOISE, ID 83709-1304
Phone number: 208-322-8381
Copy
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