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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DESIRAE CLARK

Active Sole Proprietor

DESIRAE CLARK is a Prosthetic/Orthotic Supplier healthcare provider located in KANSAS CITY, Missouri. NPI 1477100717 is currently active in the NPPES registry. Verify at CMS.

Prosthetic/Orthotic Supplier · KANSAS CITY, MO

Registration Details

NPI Number
1477100717
Provider Type
Individual
Gender
Female
NPI Issued
Aug 21, 2019 (6.7948474917412 yrs)
Last Updated
Aug 21, 2019
Sole Proprietor
Yes

Practice Information

Address
5100 LYDIA AVE
KANSAS CITY, MO, 641102608
Browse MO providers · Browse ZIP 64110
Phone
8267499147
Primary Specialty
Prosthetic/Orthotic Supplier
335E00000X

Other Prosthetic/Orthotic Supplier Providers in KANSAS CITY, MO

Name Credential NPI
VERNICE LYNN JOHNSON COSMETOLOGIST 1952760860
MISS ADRIAN CAMPBELL 1730772708
DARIA MICHELLE LUGO 1124816988
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.