Individual
SCOTT CLARK SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2900 LAKETREE CT, CHESTER, VA 23831-5232
(800) 323-0024
(804) 701-3033
Mailing address
440 MONTICELLO AVE STE 1802, NORFOLK, VA 23510-2670
(800) 323-0024
(804) 701-3033
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
11468808
VA
Other
Enumeration date
03/06/2023
Last updated
03/06/2023
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