Individual
THERESA E CLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6900 FOREST AVE, SUITE 310, RICHMOND, VA 23230-1729
(804) 249-8888
(804) 249-7246
Mailing address
6900 FOREST AVE, SUITE 310, RICHMOND, VA 23230-1729
(804) 249-8888
(804) 249-7246
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
17001722
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10125618
—
VA
01
—
54-1739189
FED TAX ID
VA
Enumeration date
05/02/2006
Last updated
07/14/2014
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