Individual
MR. CLARENCE EDWARD WESLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PERSONAL PROVIDER
Contact information
Practice address
2539 GALTS MILL RD, 2539 GALTS MILL RD, MADISON HEIGHTS, VA 24572-5808
(434) 316-4778
(434) 845-0856
Mailing address
2539 GALTS MILL RD, MADISON HEIGHTS, VA 24572-5808
(434) 316-4778
(434) 845-0856
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
—
VA
Other
Enumeration date
12/30/2011
Last updated
12/30/2011
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