Individual
CLARK KENNARD BRACKNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
530 N ELAM AVE STE A, GREENSBORO, NC 27403-1139
(336) 299-0271
Mailing address
530 N ELAM AVE STE A, GREENSBORO, NC 27403-1139
(336) 299-0271
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
788
NC
213ES0103X
Foot & Ankle Surgery Podiatrist
788
NC
213ES0131X
Foot Surgery Podiatrist
788
NC
Other
Enumeration date
04/03/2019
Last updated
08/09/2022
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