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Desirae Clark — NPI 1477100717, Kansas City, MO | NPI Central

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Desirae Clark

NPI 1477100717 · Prosthetic/Orthotic Supplier · Kansas City, MO

Provider details

NPI number: 1477100717
Entity type: Individual
Primary specialty: Prosthetic/Orthotic SupplierSuppliers
Sex: Female
Sole proprietor: Yes

Practice location

5100 Lydia Ave

Kansas City, MO 64110-2608

Phone: (826) 749-9147

More MO providers

Mailing address

Po Box 300564

Kansas City, MO 64130-0564

Registry dates

Enumerated: 2019-08-21
Last updated: 2019-08-21

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.