Individual
BRIANNA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
103 PROFESSIONAL PARK DR, CONWAY, SC 29526-9261
(843) 353-3460
(843) 353-3461
Mailing address
12788 TOUCHDOWN DR, FISHERS, IN 46037-9532
(317) 544-8926
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
05016133A
IN
225100000X
Physical Therapist
16812
TN
225100000X
Physical Therapist
CP048794T
TN
225100000X
Physical Therapist
Primary
CP053478T
SC
Other
Enumeration date
08/25/2025
Last updated
02/24/2026
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