Individual
MR. BRAD CLINTON PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
824 E 4TH ST, PITTSBURG, KS 66762-4234
(620) 704-5277
Mailing address
1102 SOUTH ROUSE, PITTSBURG, KS 66762
(620) 232-2593
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
82
KS
Other
Enumeration date
01/19/2010
Last updated
07/31/2013
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