Individual
DESI CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
888 NW HILL ST, BEND, OR 97703-2766
(971) 772-6071
Mailing address
17840 PLAINVIEW RD, BEND, OR 97703-9217
(971) 772-6071
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24427
OR
Other
Enumeration date
11/26/2019
Last updated
11/26/2019
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