| NPI | 1285958538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB A CLARK President/Owner 703-548-5588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0101041044) |
| Enumeration Date | 2010-03-16 |
| Last Update Date | 2010-03-16 |