Individual
MRS. TRACEY WILKINS CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4828 REGIMENT CT, WOODBRIDGE, VA 22193-3206
(703) 307-1680
(703) 730-1449
Mailing address
4828 REGIMENT CT, WOODBRIDGE, VA 22193-3206
(703) 307-1680
(703) 730-1449
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
1201073826
VA
Other
Enumeration date
05/17/2017
Last updated
07/21/2022
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