Provider Demographics
NPI:1245319540
Name:CLARK AND ASSOCIATES, INC.
Entity type:Organization
Organization Name:CLARK AND ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BATHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
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 1:3109 S CENTER ST # 102
Practice Address - Street 2:
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158
Practice Address - Country:US
Practice Address - Phone:641-753-0067
Practice Address - Fax:641-753-1106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0487835Medicaid
IA0487835Medicaid