Provider Demographics
NPI:1578919593
Name:CLARK AND ASSOCIATES, INC
Entity Type:Organization
Organization Name:CLARK AND ASSOCIATES, INC
Other - Org Name:CLARK KUNTZ AND ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PARTNER
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, LCPO
Authorized Official - Phone:319-233-8911
Mailing Address - Street 1:527 PARK LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702-5236
Mailing Address - Country:US
Mailing Address - Phone:319-233-8911
Mailing Address - Fax:319-287-5350
Practice Address - Street 1:4301 SERGEANT RD
Practice Address - Street 2:#105
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-4726
Practice Address - Country:US
Practice Address - Phone:712-224-2378
Practice Address - Fax:712-224-2379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-09
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier