Provider Demographics
NPI:1912184433
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 1:646 S MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-5041
Mailing Address - Country:US
Mailing Address - Phone:641-422-1423
Mailing Address - Fax:641-423-5233
Practice Address - Street 1:634 S MONROE AVE
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-5041
Practice Address - Country:US
Practice Address - Phone:641-422-1423
Practice Address - Fax:641-423-5233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA191218443Medicaid
IA4592520004Medicare NSC