Individual
BRANDON CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3310 EASTERN AVE, BALTIMORE, MD 21224-4108
(667) 239-5502
Mailing address
8127 EVENING STAR DR UNIT 251, PASADENA, MD 21122-2487
(443) 980-5236
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
ADT3350
MD
Other
Enumeration date
06/10/2024
Last updated
06/13/2024
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