Individual
CLARENCE RYAN BRACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
1330 BOILING SPRINGS RD, SUITE 1600B, SPARTANBURG, SC 29303-4201
(864) 582-0019
Mailing address
1330 BOILING SPRINGS RD, SUITE 1600B, SPARTANBURG, SC 29303-4201
(864) 582-0019
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3997
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3997
STATE LICENSE NUMBER
SC
Enumeration date
08/04/2008
Last updated
08/04/2008
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