Individual
MR. GRENVILLE CLARK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.P.T.
Contact information
Practice address
5301 PROVIDENCE RD, SUITE 80, VIRGINIA BEACH, VA 23464-4128
(757) 467-1900
(757) 467-7900
Mailing address
18 MEDICAL PARK DR, ASHEVILLE, NC 28803-2493
(828) 785-4700
(828) 552-5566
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2305202681
VA
225100000X
Physical Therapist
Primary
P11167
NC
Other
Enumeration date
05/23/2006
Last updated
11/10/2020
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