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1760049068
JACOB DAVID CLARK
MADISON, AL
NPI
1760049068
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
152W00000X Optometrist
(Licence: AL S-E20-TA-B53)
Enumeration Date
2019-05-22
Last Update Date
2023-10-13
Business Address
Dr. JACOB DAVID CLARK OD
7880 OLD MADISON PIKE
MADISON, AL 35758-1435
Phone number: 256-772-8711
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Mailing Address
Dr. JACOB DAVID CLARK OD
PO BOX 207243
DALLAS, TX 75320-7243
Phone number: 636-200-4393
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