Clark, Desirae
Clark, Desirae is an sole proprietor health care provider with primary practice located at 5100 Lydia Ave , Kansas City MO 64110-2608. She recently has only one registered license in Suppliers / Prosthetic/Orthotic Supplier, which is considered as her primary health care specialty. Clark, Desirae can be contacted via phone (826) 749-9147.Contact Information
Primary practice address
5100 Lydia Ave
Kansas City MO 64110-2608
Phone: (826) 749-9147
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Prosthetic/Orthotic Supplier | 335E00000X |
Profile Details
| NPI number | 1477100717 |
|---|---|
| LBN Legal business name | Clark, Desirae |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 21st, 2019 |
| Last updated | Aug 21st, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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