Individual
MR. BRYAN THOMAS CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RADT
Contact information
Practice address
3125 MCHENRY AVE STE D, MODESTO, CA 95350-1451
(209) 523-6900
Mailing address
700 N QUINCY RD, TURLOCK, CA 95380-4334
(209) 277-4386
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
507004599
CA
Other
Enumeration date
04/30/2019
Last updated
04/30/2019
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