Individual
JORDAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 N SHENANDOAH AVE, FRONT ROYAL, VA 22630-3547
(540) 636-0300
Mailing address
1000 N SHENANDOAH AVE, FRONT ROYAL, VA 22630-3547
(540) 636-0300
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1043888
VA
Other
Enumeration date
06/11/2015
Last updated
06/11/2015
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