Healthcare Provider Details

I. General information

NPI: 1952409906
Provider Name (Legal Business Name): CLARK'S ORTHOPEDIC & MEDICAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

816 9TH ST S
GREAT FALLS MT
59405-2136
US

IV. Provider business mailing address

816 9TH ST S
GREAT FALLS MT
59405-2136
US

V. Phone/Fax

Practice location:
  • Phone: 406-452-8428
  • Fax: 406-452-8741
Mailing address:
  • Phone: 406-452-8428
  • Fax: 406-452-8741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberDOES NOT APPLY IN MT
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: RICHARD L. CLARK
Title or Position: PRESIDENT
Credential: CPO
Phone: 406-452-8428