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Lacey Clark
NPI 1477000347 · on the registry since 2016
Practice
- Address
- 5419 Highway 25 Ste R
Flowood, MS 39232 - Phone
- (601) 479-5392
- Organisation at this address
- The Wellness Spa, Llc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 225700000X
225700000X
- Licence states on file
- MS
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2016-09-07
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi