National Provider Identifier Database

TRACEY WILKINS CLARK
Prosthetist

An individual skilled in the practice, making, use, and application to individual cases of an artificial substitute for a missing body part, such as an arm or leg, eye or tooth, used for functional or cosmetic reasons, or both


Contact Information

TRACEY WILKINS CLARK
4828 REGIMENT CT
WOODBRIDGE, VA22193-3206
Phone: 703-307-1680
Fax: 703-730-1449
Website:
Specialty Taxonomy Code
* Prosthetist 224P00000X

* Indicates primary specialty

NPI Profile & details for TRACEY WILKINS CLARK

NPI Number 1821525163
Credentials
Entity Individual
Enumeration date 05/17/2017
Last updated 07/21/2022 - About 4 years ago
Sole proprietor1 Yes
Identifiers
  • VA License #: 1201073826
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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