Ricky Lynn Clark
Athletic Trainer · Brandon, MS
Practice location
904 Municipal DrBrandon, MS 39042-2973
- Phone
- (601) 724-7310
NPI record
- NPI
- 1639608136
- Entity type
- Individual (Type 1)
- Enumeration date
- June 8, 2017
- Last updated
- June 8, 2017
- Sole proprietor
- Yes
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| Athletic Trainer Primary | 2255A2300X |
AT0557 | MS |
Mailing address
103 Pine CVClinton, MS 39056-5825
About Ricky Clark
Ricky Lynn Clark is a healthcare provider registered in the NPI registry with the primary taxonomy Athletic Trainer (code 2255A2300X). The practice location is 904 Municipal Dr, Brandon, MS 39042-2973. The NPI number 1639608136 was assigned on June 8, 2017 and the record was last updated on June 8, 2017.
Ricky Clark lists a license in the registry: #AT0557 (MS) for Athletic Trainer. License numbers are self-reported to NPPES; verify them with the state licensing board.
Frequently asked questions
What is the NPI number of Ricky Lynn Clark?
The NPI number is 1639608136.
What is the phone number of Ricky Clark?
The phone number listed for the practice location is (601) 724-7310.
Where is Ricky Clark located?
904 Municipal Dr, Brandon, MS 39042-2973.
What is the taxonomy code for Ricky Clark?
The primary taxonomy code is 2255A2300X – Athletic Trainer.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.
Other Athletic Trainer providers in Brandon
- Faith Nicole Smith, PTA, LAT, ATC904 Municipal Dr
- Benjamin Long, ATC314 Siltstone RDG
- Christopher Cody Garcia234 E Pinebrook Dr
- Blake Harrison Hines, ATC, NASM-PES, MA214 Meadowlands Dr