Individual
BRANDON CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4725 US HIGHWAY 98 S STE 101-102, LAKELAND, FL 33812-4334
(863) 274-9700
Mailing address
5901 E FOWLER AVE STE 100, TEMPLE TERRACE, FL 33617-2305
(813) 987-9700
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA34319
FL
Other
Enumeration date
10/01/2025
Last updated
10/01/2025
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