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1407903693
MARK ALLEN CLARK
FREDERICKSBURG, VA
NPI
1407903693
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: VA 0024166868)
Enumeration Date
2007-01-03
Last Update Date
2012-11-07
Business Address
Mr. MARK ALLEN CLARK
111 PARK HILL DR # A
FREDERICKSBURG, VA 22401-3357
Phone number: 540-368-1044
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Mailing Address
Mr. MARK ALLEN CLARK
22445 CONSERVANCY DR
ASHBURN, VA 20148-8068
Phone number: 540-368-1044
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