Individual
HENRY LARRY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
550 W PIONEER BLVD STE 204, MESQUITE, NV 89027-1406
(702) 345-4065
(702) 345-4077
Mailing address
PO BOX 7173, BUNKERVILLE, NV 89007-0173
(702) 335-0241
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
374700000X
Technician
Primary
—
—
3747A0650X
Attendant Care Provider
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
09/05/2019
Last updated
09/05/2019
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