person
Desirae Clark
Prosthetic/Orthotic Supplier in Kansas City, Missouri
NPI 1477100717

Desirae Clark is a Prosthetic/Orthotic Supplier based in Kansas City, MO. Desirae Clark practices in Kansas City, MO. The NPI Number for Desirae Clark is 1477100717 and holds a License No. (Missouri).

The current practice location address for Desirae Clark is 5100 Lydia Ave, Kansas City, MO and can be reached out via phone at 826-749-9147. You can also correspond with Desirae Clark through the mailing address at PO BOX 300564, KANSAS CITY, MO - 64130-0564 (mailing address contact number: 816-749-9147).

Location: 5100 Lydia Ave, Kansas City, MO, 64130-0564
person
Provider Profile Details
NPI Number
1477100717
Provider Name
Desirae Clark
Credential
Provider Entity Type
Individual
Gender
Female
Address
5100 Lydia Ave, Kansas City, MO, 64130-0564
Phone Number
826-749-9147
Fax Number
Provider Enumeration Date
08/21/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
5100 Lydia Ave
City
State
Zip
64110-2608
Phone Number
826-749-9147
Fax Number
person
Provider Business Mailing Address Details
Address
5100 Lydia Ave
City
State
Zip
64110-2608
Phone Number
826-749-9147
Fax Number
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
License No.
()
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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