Clark, Lacey Green

Clark, Lacey Green is an individual health care provider with primary practice located at 5419 Highway 25 Ste R , Flowood MS 39232-6343. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist, which is considered as her primary health care specialty. Clark, Lacey Green can be contacted via phone (601) 479-5392.

Contact Information

Primary practice address
5419 Highway 25 Ste R Flowood MS 39232-6343
Phone: (601) 479-5392
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist 225700000X 1384 Mississippi

Profile Details

NPI number 1477000347
LBN Legal business name Clark, Lacey Green
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 7th, 2016
Last updated Sep 7th, 2016 - about 9 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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