Clark, Kent Edward
Clark, Kent Edward is an sole proprietor health care provider with primary practice located at 15B Loudoun St Sw , Leesburg VA 20175-2908. He recently has 2 registered licenses in different health care specialties including Chiropractic Providers / Nutrition, Chiropractic Providers / Chiropractor. Chiropractic Providers / Chiropractor is his primary health care specialty. Clark, Kent Edward can be contacted via phone (703) 779-7909.Contact Information
Primary practice address
15B Loudoun St Sw
Leesburg VA 20175-2908
Phone: (703) 779-7909
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Nutrition | 111NN1001X | 8302 | Arizona |
| Chiropractic Providers / Chiropractor | 111N00000X | 0104-557256 | Virginia |
Profile Details
| NPI number | 1679857544 |
|---|---|
| LBN Legal business name | Clark, Kent Edward |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 10th, 2011 |
| Last updated | Sep 14th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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