Individual
MR. BRETT BENJAMIN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
110 WEST RD, SUITE 105, TOWSON, MD 21204-2316
(410) 321-4901
Mailing address
110 WEST RD, SUITE 105, TOWSON, MD 21204-2316
(410) 321-4901
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17644
MD
Other
Enumeration date
05/19/2006
Last updated
11/06/2007
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