Individual
BEVERLY CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2247 COLSTON ST, PETERSBURG, VA 23805-2203
(765) 977-6296
Mailing address
2400 OAKLAWN BLVD TRLR 13, HOPEWELL, VA 23860-5045
(804) 247-3528
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
VA
Other
Enumeration date
01/03/2020
Last updated
01/03/2020
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