Organization
K & L ENTERPRISE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENT EDWARD CLARK DC (OWNER/MEMBER)
(703) 779-7909
Entity
Organization
Contact information
Practice address
15B LOUDOUN ST SW, LEESBURG, VA 20175-2908
(703) 779-7909
Mailing address
15B LOUDOUN ST SW, LEESBURG, VA 20175-2908
(703) 779-7909
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104-557256
VA
Other
Enumeration date
08/04/2015
Last updated
09/21/2015
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