Kenny Clark SR.

NPI #1174373252 in Shaker Heights, Ohio

Provider Information

NPI Number: 1174373252
Entity Type: Individual
Name: Kenny Clark SR.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Driver
Enumeration Date: Mar 25, 2024
Last Updated: Mar 25, 2024

Practice Location

Address: 3686 INGLESIDE RD
City: Shaker Heights
State: Ohio
ZIP Code: 44122-5056
Phone: (216) 816-8129

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Driver	172A00000X	Primary

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