| NPI | 1194101824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENT EDWARD CLARK Owner/Member 703-779-7909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: VA 0104-557256) |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2015-09-21 |