Individual
ANTONIO O'NEIL CLINKSCALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
103 SURREY DR, RUTHER GLEN, VA 22546-1035
(804) 994-7998
Mailing address
103 SURREY DR, RUTHER GLEN, VA 22546-1035
(804) 994-7998
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81-5150005
—
VA
Enumeration date
03/02/2019
Last updated
03/02/2019
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