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Contact Information

TRACEY WILKINS CLARK
4828 REGIMENT CT
WOODBRIDGE, VA22193-3206
 Phone: 703-307-1680
 Fax: 703-730-1449
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Prosthetist

224P00000X 56 Individual Certified Prosthetist
Indicates primary specialty

NPI Profile & details for TRACEY WILKINS CLARK · (Female)

NPI # 1821525163
Status Active
Credentials
Entity Individual
Enumeration date 05/17/2017
Last updated 07/21/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • VA License # 1201073826
Hospital affiliation(s) Not Available
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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