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

Ursula Lori Clark

Individual provider Contractor · NPI 1710562129

Ursula Lori Clark is a Contractor in Lake Park, Georgia. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

4700 Rolling Pine Dr Apt D25
Lake Park, GA 31636-4935
Phone: (305) 877-6401
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Contractor (primary) Taxonomy 171W00000X

Record details

NPI number1710562129
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 17, 2021
Last updated in NPPESMarch 17, 2021
Certification dateMarch 17, 2021
Mailing address4700 Rolling Pine Dr Apt D25, Lake Park, GA 31636-4935

Other providers in Lake Park