BRIAN THOMAS CLARK

VIRGINIA BEACH, VA
NPI1093744427
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2006-06-30
Last Update Date2007-07-08
Business Address
-- BRIAN THOMAS CLARK IDC
3972 SHADY OAKS DR
VIRGINIA BEACH, VA 23455-1628
Phone number: 757-630-7081
Mailing Address
-- BRIAN THOMAS CLARK IDC
3972 SHADY OAKS DR
VIRGINIA BEACH, VA 23455-1628
Phone number: 757-630-7081
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