William Kyle Clark, LMT
Individual provider Active NPI Massage Therapist · Morganfield, KY
NPI 1487865044 · NPPES record last updated Mar 6, 2023
Key facts
- NPI
- 1487865044
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 262418 (KY)
- Practice address
- 313 W Main St
Morganfield, KY 42437-1424 - Phone
- (270) 952-5450
- NPI assigned
- May 25, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 262418 | KY | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 262418 | KY | Yes |
Addresses
Primary practice location
313 W Main St
Morganfield, KY 42437-1424
Mailing address
PO Box 641268
Cincinnati, OH 45264-0304
Phone (270) 745-1467
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 91011148 | Medicaid | KY |
Other providers in Morganfield, KY
- Jennifer Lynn Bercaw
- Ashleigh Bolton
- Breckinridge Services Inc
- Farrah N Burgess
- William H Clapp
- Tara Lynn Clements
- Macy Lura Thompson Clevidence
- Peter Pruitt Cohron
- Rachel L Creighton
- Michelle Daugherty
All providers in Morganfield, KY · Massage Therapist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.