Crystal Clark

Driver · Blacksburg, VA

Individual Active NPI

NPI number 1477213619

Practice location

3700 S Main St
Blacksburg, VA 24060-7017
Phone
(540) 951-1111

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NPI record

NPI
1477213619
Entity type
Individual (Type 1)
Enumeration date
December 29, 2021
Last updated
December 29, 2021
Certified
December 29, 2021
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Driver Primary 172A00000X A69874069 VA

Mailing address

506 Essex Ct # 1
Blacksburg, VA 24060-6464
Phone
(804) 429-7185

About Crystal Clark

Crystal Clark is a healthcare provider registered in the NPI registry with the primary taxonomy Driver (code 172A00000X). The practice location is 3700 S Main St, Blacksburg, VA 24060-7017. The NPI number 1477213619 was assigned on December 29, 2021 and the record was last updated on December 29, 2021.

Crystal Clark lists a license in the registry: #A69874069 (VA) for Driver. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Crystal Clark?

The NPI number is 1477213619.

What is the phone number of Crystal Clark?

The phone number listed for the practice location is (540) 951-1111.

Where is Crystal Clark located?

3700 S Main St, Blacksburg, VA 24060-7017.

What is the taxonomy code for Crystal Clark?

The primary taxonomy code is 172A00000X – Driver.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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