Individual
BRUCE BRANDON CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3205 S MADISON ST, MUNCIE, IN 47302-5604
(765) 283-4329
Mailing address
3205 S MADISON ST, MUNCIE, IN 47302-5604
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/09/2022
Last updated
03/09/2022
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