Search › Virginia › 101YA0400X
Kevin Clark
NPI 1245851104 · on the registry since 2020 · sole proprietor
Practice
- Address
- 10615 Judicial Dr Ste 403
Fairfax, VA 22030 - Phone
- (703) 565-3783
- Fax
- (571) 285-4001
- Organisation at this address
- Axioms Health Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 10
Registry record
- Primary taxonomy
- 101YA0400X
101YA0400X
- Licence states on file
- VA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-04-26
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Virginia