Individual
BRIAN HOWARD CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1300 S MONTGOMERY AVE, SHEFFIELD, AL 35660-6334
(256) 386-4005
(256) 386-4685
Mailing address
2101 VIRGINIA AVE, MUSCLE SHOALS, AL 35661-2633
(256) 314-0491
(256) 386-4067
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH3211
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51513137
BLUE CROSS
AL
Enumeration date
01/29/2007
Last updated
07/08/2007
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