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1740844240
BRYAN THOMAS CLARKE
MODESTO, CA
NPI
1740844240
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 507004599)
Enumeration Date
2019-04-30
Last Update Date
2019-04-30
Business Address
Mr. BRYAN THOMAS CLARKE RADT
3125 MCHENRY AVE STE D
MODESTO, CA 95350-1451
Phone number: 209-523-6900
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Mailing Address
Mr. BRYAN THOMAS CLARKE RADT
700 N QUINCY RD
TURLOCK, CA 95380-4334
Phone number: 209-277-4386
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