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1871872416
BRANDON C CLARK
DEERFIELD BEACH, FL
NPI
1871872416
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
(Licence: FL 103K00000X)
Enumeration Date
2011-08-14
Last Update Date
2015-01-02
Business Address
-- BRANDON C CLARK
500 FAIRWAY DR
DEERFIELD BEACH, FL 33441-1814
Phone number: 954-603-7885
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Mailing Address
-- BRANDON C CLARK
6 ROSEBERRY CIR
PORT WENTWORTH, GA 31407-5612
Phone number: 850-567-5657
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