Individual
LACY RAE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
80 HIGHWAY 2227, SOMERSET, KY 42503-1562
(606) 485-9323
Mailing address
80 KY-2227, SOMERSET, KY 42503
(606) 485-9323
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
KY
Other
Enumeration date
04/06/2026
Last updated
04/06/2026
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