Most Relevant Information
Provider Data
| NPI Number: | 1003379769 |
| Provider Name: | BRADY CLARK |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/10/2019 |
| Last Updated: | 05/16/2024 |
Provider Practice Location
1750 INDEPENDENCE AVE
KANSAS CITY
MO
641061453
Practice Location Phone/Fax
| Phone: | 8166547000 |
| Fax: |
Provider Mailing Location
W2390 COUNTY ROAD I
MARKESAN
WI
539467502
Provider Mailing Phone/Fax
| Phone: | 9202952552 |
| Fax: |