Individual
MRS. ADRIAN DENISE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10543 S CRATER RD, SOUTH PRINCE GEORGE, VA 23805-7333
(804) 431-5585
Mailing address
PO BOX 3601, PETERSBURG, VA 23805-3601
(804) 605-0388
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002078009
VA
Other
Enumeration date
02/11/2020
Last updated
02/11/2020
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