Provider Demographics
NPI:1467531764
Name:CLARK AND ASSOCIATES, INC.
Entity Type:Organization
Organization Name:CLARK AND ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:L
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA CPO
Authorized Official - Phone:319-233-8911
Mailing Address - Street 1:1635 ASSOCIATES DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-2279
Mailing Address - Country:US
Mailing Address - Phone:563-556-5415
Mailing Address - Fax:563-556-0256
Practice Address - Street 1:1635 ASSOCIATES DR
Practice Address - Street 2:SUITE 104
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002-2279
Practice Address - Country:US
Practice Address - Phone:563-556-5415
Practice Address - Fax:563-556-0256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0481283Medicaid
IA4592520003Medicare ID - Type UnspecifiedPROVIDER NUMBER