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1306134317
KRISTEN NICOLE CLARK
CHAMPAIGN, IL
NPI
1306134317
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
152W00000X Optometrist
(Licence: IL 046010447)
Enumeration Date
2011-07-12
Last Update Date
2011-08-05
Business Address
-- KRISTEN NICOLE CLARK OD
2435 VILLAGE GREEN PL
CHAMPAIGN, IL 61822-7676
Phone number: 800-325-7706
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Mailing Address
-- KRISTEN NICOLE CLARK OD
PO BOX 757
BLOOMINGTON, IL 61702-0757
Phone number: 800-325-7706
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