SearchVirginia101YA0400X

John Clark

NPI 1699824763 · on the registry since 2007

Practice

Address
10390 Democracy Ln
Fairfax, VA 22030
Phone
(703) 219-2578
Clinicians at this address
3

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
2007-07-08

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