Provider Demographics
NPI:1447723697
Name:CLARK AND ASSOCIATES, INC
Entity type:Organization
Organization Name:CLARK AND ASSOCIATES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:LESLIE
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, CPO, LPO
Authorized Official - Phone:319-233-8911
Mailing Address - Street 1:527 PARK LN STE 100
Mailing Address - Street 2:
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 1:2431 CORAL CT STE 3
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2838
Practice Address - Country:US
Practice Address - Phone:319-209-6005
Practice Address - Fax:319-359-7903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-09
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0714494Medicaid