Brandon Clark Valid NPI

Individual provider · Physical Therapy Assistant · Lakeland, FL

NPI

1053285353

Type

Individual (Type 1)

Primary specialty

Physical Therapy Assistant

Specialty group

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy code

225200000X

License number

PTA34319 (FL)

Sex

Male

Sole proprietor

Yes

Enumerated

2025-10-01

Last updated

2025-10-01