Individual
ANGEL LEE CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
7015 CARNATION ST APT 214, RICHMOND, VA 23225-5234
(919) 327-9666
Mailing address
501 MONTGOMERY DR, RUTHER GLEN, VA 22546-1137
(804) 306-0698
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306604246
VA
225700000X
Massage Therapist
0019004787
VA
Other
Enumeration date
03/02/2017
Last updated
03/02/2017
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