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Individual

MS. TAMMY V CLARK

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
2300 WASHINGTON AVE, FREDERICKSBURG, VA 22401-3340
(540) 372-1100
(540) 373-8643
Mailing address
11150 SUNBURST LN, APT. A, FREDERICKSBURG, VA 22407-7654
(540) 898-4655
(540) 373-8643

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000820
VA

Other

Enumeration date
03/31/2006
Last updated
07/08/2007
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