Brandon Clark

NPI #1053285353 in Lakeland, Florida

Provider Information

NPI Number: 1053285353
Entity Type: Individual
Name: Brandon Clark
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Oct 1, 2025
Last Updated: Oct 1, 2025

Practice Location

Address: 4725 US HIGHWAY 98 S STE 101-102
City: Lakeland
State: Florida
ZIP Code: 33812-4334
Phone: (863) 274-9700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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