Individual
JESSICA I CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
160 KENDAL DR APT 200, LEXINGTON, VA 24450-1790
(549) 463-1910
Mailing address
PO BOX 673, TROUTVILLE, VA 24175-0673
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306605516
VA
Other
Enumeration date
08/14/2026
Last updated
08/14/2026
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