Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ricky Lynn Clark

Individual provider Athletic Trainer · NPI 1639608136

Ricky Lynn Clark is an Athletic Trainer in Brandon, Mississippi. Practices as a sole proprietor. Licensed in Mississippi.

Licensed in
MS
In the registry since
2017

Practice location Address checks out

904 Municipal Dr
Brandon, MS 39042-2973
Phone: (601) 724-7310
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence AT0557 (MS)

Record details

NPI number1639608136
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 8, 2017
Last updated in NPPESJune 8, 2017

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