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General NPI Number Information
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NPI Number | 1952795270
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Entity Type | Organization
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Legal Business Name | CLK CONSTRUCTION, INC.
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Dates
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Enumeration Date | 03/25/2015
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Last Update Date | 03/25/2015
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Provider Practice Location Address
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Address Line | 107 KEMPA DRIVE, NE
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City | COPPER HILL
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State | VA
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Zip | 24079
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Country | US
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Telephone | 540-309-6975
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Fax | 540-929-4273
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Provider Business Mailing Address
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Address Line | PO BOX 89
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City | BENT MOUNTAIN
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State | VA
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Zip | 24059-0089
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Country | US
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Telephone | 540-309-6975
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Fax | 540-929-4273
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CARL L KEMPA
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Credential |
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Telephone | 540-309-6975
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 2705075085A
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License Number State | VA
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