BRANTRIESA CLARK

COVINGTON, GA
NPI1659883684
Former NameBRANTRIESA HUTCHINSON
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: GA  8587)
Additional Taxonomies207RC0000X Internal Medicine, Cardiovascular Disease
(Licence: GA  8587)
Enumeration Date2017-10-31
Last Update Date2025-06-19
Business Address
Mrs. BRANTRIESA CLARK PA
4181 HOSPITAL DR NE STE 205
COVINGTON, GA 30014-2541
Phone number: 678-342-8677
Mailing Address
Mrs. BRANTRIESA CLARK PA
1829 LAWRENCEVILLE HWY
DECATUR, GA 30033-5728
Phone number: