Individual
BRAYDEN CLAYE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11143 PARKVIEW PLAZA DR STE 100, FORT WAYNE, IN 46845-1728
(260) 266-7400
(260) 266-7439
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
05015560A
IN
Other
Enumeration date
05/31/2024
Last updated
06/04/2024
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