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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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