DESIRAE CLARK

KANSAS CITY, MO
NPI1477100717
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy335E00000X Prosthetic/Orthotic Supplier
Enumeration Date2019-08-21
Last Update Date2019-08-21
Business Address
DESIRAE CLARK
5100 LYDIA AVE
KANSAS CITY, MO 64110-2608
Phone number: 826-749-9147
Mailing Address
DESIRAE CLARK
PO BOX 300564
KANSAS CITY, MO 64130-0564
Phone number: 816-749-9147