Provider Demographics
NPI:1952629156
Name:CLARK AUDIOLOGY AND HEARING AID CENTER
Entity Type:Organization
Organization Name:CLARK AUDIOLOGY AND HEARING AID CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:484-231-1340
Mailing Address - Street 1:401 W GERMANTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:EAST NORRITON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-4229
Mailing Address - Country:US
Mailing Address - Phone:484-231-1340
Mailing Address - Fax:484-231-1350
Practice Address - Street 1:401 W GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19403-4229
Practice Address - Country:US
Practice Address - Phone:484-231-1340
Practice Address - Fax:484-231-1350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-12
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty