Kenny Clark Sr.
Kenny Clark Sr. is a Driver in Shaker Heights, Ohio. Practices as a sole proprietor. Registered with an NPI since 2024.
- In the registry since
- 2024
Practice location Address checks out
3686 Ingleside RdShaker Heights, OH 44122-5056
Phone: (216) 816-8129
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Driver (primary) | Taxonomy 172A00000X |
|---|
Record details
| NPI number | 1174373252 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | March 25, 2024 |
| Last updated in NPPES | March 25, 2024 |
| Certification date | March 20, 2024 |
| Mailing address | 11811 Shaker Blvd, Cleveland, OH 44120-1931 |
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