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Individual

VALENICA EGGLESTON-CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1107A BROOKDALE ST, MARTINSVILLE, VA 24112-4501
(276) 670-3300
(276) 634-0379
Mailing address
1107A BROOKDALE ST, MARTINSVILLE, VA 24112-4501
(276) 670-3300
(276) 634-0379

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101243377
VA
207Q00000X
Family Medicine Physician
129166
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1316069933
VA
Enumeration date
04/04/2007
Last updated
08/11/2011
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