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Individual

MRS. BRANDY LEE CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1575 CHATTANOOGA AVE STE 1, DALTON, GA 30720-2672
(706) 876-2130
Mailing address
1575 CHATTANOOGA AVE STE 1, DALTON, GA 30720-2672
(706) 876-2130

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
163349
GA

Other

Enumeration date
12/10/2019
Last updated
12/10/2019
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