Individual
MR. WILLIAM CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
8501 SILVERBROOK RD, LORTON, VA 22079-3015
(703) 446-1563
Mailing address
8501 SILVERBROOK RD, LORTON, VA 22079-3015
(703) 446-1563
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
020202230
VA
Other
Enumeration date
04/10/2015
Last updated
04/10/2015
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