Individual
AVERY BRUNSON CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1151 BOWERIE CHASE, POWDER SPRINGS, GA 30127-4940
(770) 401-4634
Mailing address
1151 BOWERIE CHASE, POWDER SPRINGS, GA 30127-4940
(770) 401-4634
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
GA
Other
Enumeration date
11/19/2025
Last updated
11/19/2025
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