Clark, Destiny

Clark, Destiny is an sole proprietor health care provider with primary practice located at 6811 Old Canton Rd Apt 3305 , Ridgeland MS 39157-1247. She recently has only one registered license in Suppliers / Prosthetic/Orthotic Supplier, which is considered as her primary health care specialty. Clark, Destiny can be contacted via phone (769) 231-7366.

Contact Information

Primary practice address
6811 Old Canton Rd Apt 3305 Ridgeland MS 39157-1247
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Prosthetic/Orthotic Supplier 335E00000X Mississippi

Profile Details

NPI number 1700578010
LBN Legal business name Clark, Destiny
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 24th, 2023
Last updated May 24th, 2023 - about last year

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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