MRS. Virginia J Clark

NPI #1538580634 in Holiday, Florida

Provider Information

NPI Number: 1538580634
Entity Type: Individual
Name: MRS. Virginia J Clark
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Dec 17, 2013
Last Updated: Dec 17, 2013

Practice Location

Address: 4806 MILE STRETCH DR
City: Holiday
State: Florida
ZIP Code: 34690-4358
Phone: (727) 943-7162

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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