Provider Demographics
NPI:1730313651
Name:CLARK AND ASSOCIATES, INC.
Entity Type:Organization
Organization Name:CLARK AND ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
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,CPO
Authorized Official - Phone:319-233-8911
Mailing Address - Street 1:202 10TH ST SE
Mailing Address - Street 2:SUITE 160
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-2433
Mailing Address - Country:US
Mailing Address - Phone:319-294-5886
Mailing Address - Fax:319-294-5988
Practice Address - Street 1:202 10TH ST SE
Practice Address - Street 2:SUITE 160
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-2404
Practice Address - Country:US
Practice Address - Phone:319-294-5886
Practice Address - Fax:319-294-5988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1730313651Medicaid
IA1730313651Medicaid