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Individual
VIRGIL LEE CLARK
Active
Individual
VIRGIL LEE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
REHABILITATION PRAC
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
06/19/2020
Last updated
06/19/2020
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