Organization
CLARK FAMILY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TARA CLARK D.O. (PHYSICIAN/OWNER)
(816) 356-2020
Entity
Organization
Contact information
Practice address
4240 BLUE RIDGE BLVD, SUITE 611, KANSAS CITY, MO 64133-1713
(816) 356-2020
(816) 356-2022
Mailing address
4240 BLUE RIDGE BLVD, SUITE 611, KANSAS CITY, MO 64133-1713
(816) 356-2020
(816) 356-2022
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2004023907
MO
Other
Enumeration date
05/12/2011
Last updated
02/20/2012
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