Individual
BRAD A. CLEMMENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
(405) 456-1000
Mailing address
408 CEDARBURG CT, YUKON, OK 73099-5768
(405) 650-8438
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1659
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659
PT LICENSE
OK
Enumeration date
09/22/2006
Last updated
12/21/2022
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