Individual
EDWARD CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1310 6TH ST NW, WASHINGTON, DC 20001-3495
(202) 234-7414
Mailing address
4202 58TH ADVENUE#127, BLADENSBURG, MD 20710
(240) 481-5841
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
ACTIVE
DC
Other
Enumeration date
06/18/2019
Last updated
06/18/2019
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