Individual
MR. CLARK BRANDON RASBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
23 MASON ST, LAUREL, MS 39440-4437
(601) 399-0534
(601) 399-2810
Mailing address
15 BLACKBERRY DR., LAUREL, MS 39443
(601) 425-4473
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4025
MS
Other
Enumeration date
03/02/2007
Last updated
07/08/2007
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