Organization
CLARKES HAIR DESIGN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE MOORE (OWNER)
(863) 212-6008
Entity
Organization
Contact information
Practice address
2434 US HIGHWAY 92 E, LAKELAND, FL 33801-2650
(863) 212-6008
Mailing address
4086 SUNDANCE PLACE LOOP, MULBERRY, FL 33860-0150
(863) 212-6008
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
CLO210755
FL
Other
Enumeration date
12/18/2017
Last updated
03/14/2018
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