Individual
CHARLA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 LAKESIDE DR, LYNCHBURG, VA 24501-3116
(434) 316-5000
(540) 224-1906
Mailing address
1600 LAKESIDE DR, LYNCHBURG, VA 24501-3116
(434) 316-5000
(540) 224-1906
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002073062
VA
Other
Enumeration date
11/12/2025
Last updated
11/12/2025
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