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1629228093
MYRA LESLIE CLARK
MECHANICSVILLE, VA
NPI
1629228093
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner Family
(Licence: VA 0024170893)
Enumeration Date
2008-09-23
Last Update Date
2013-10-11
Business Address
MYRA LESLIE CLARK PHD, NP-C
7048 MECHANICSVILLE TPKE
MECHANICSVILLE, VA 23111-7101
Phone number: 804-730-9498
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Mailing Address
MYRA LESLIE CLARK PHD, NP-C
2485 RANSON CT
CHARLOTTESVILLE, VA 22911-8622
Phone number: 434-293-0660
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