Individual provider · Type 1 NPI
Kenny Clark Sr.
Driver · Shaker Heights, OH
NPI number
1174373252
Active
Practice location
3686 Ingleside Rd
Shaker Heights, OH 44122-5056
Mailing address
11811 Shaker Blvd
Cleveland, OH 44120-1931
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Driver Primary | 172A00000X | None listed |
Driver: A person employed to operate a motor vehicle as a carrier of persons or property.
Another provider at this address
Other driver providers in Shaker Heights
About NPI 1174373252
Kenny Clark Sr.'s National Provider Identifier is 1174373252, issued on Mar 25, 2024. The primary taxonomy on file is Driver (172A00000X), and the practice location is in Shaker Heights, OH. The record was last updated on Mar 25, 2024.