Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Desirae Clark

Individual provider Prosthetic/Orthotic Supplier · NPI 1477100717

Desirae Clark is a Prosthetic/Orthotic Supplier in Kansas City, Missouri. Practices as a sole proprietor. Registered with an NPI since 2019.

In the registry since
2019
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Practice location Address checks out

5100 Lydia Ave
Kansas City, MO 64110-2608
Phone: (826) 749-9147
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Prosthetic/Orthotic Supplier (primary) Taxonomy 335E00000X

Record details

NPI number1477100717
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 21, 2019
Last updated in NPPESAugust 21, 2019

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