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Individual

MRS. DEBRA DIANE CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
104 53RD AVE E, BRADENTON, FL 34203-4702
(941) 727-3529
Mailing address
104 53RD AVE E, BRADENTON, FL 34203-4702
(994) 172-7352

Taxonomy

Speciality
Code
Description
License number
State
173C00000X
Reflexologist
Primary
173C00000X
FL

Other

Enumeration date
07/01/2009
Last updated
07/01/2009
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