Individual
MR. THOMAS MARTIN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
9300 DEWITT LOOP, FORT BELVOIR, VA 22060-5285
(571) 231-3224
Mailing address
807 CHURCH ST, ALEXANDRIA, VA 22314-4203
(516) 754-8855
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
725069
NY
Other
Enumeration date
07/19/2021
Last updated
02/01/2023
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