Mr. Bradley Dewayne Clark
Mr. Bradley Dewayne Clark is a Peer Specialist in Tulsa, Oklahoma. Registered with an NPI since 2022.
- In the registry since
- 2022
Practice location Address checks out
252 W 17th PlTulsa, OK 74119-4654
Phone: (918) 200-9065
Fax: (918) 585-9543
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Specialties & licences
| Peer Specialist (primary) | Taxonomy 175T00000X |
|---|
Record details
| NPI number | 1457008955 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | March 4, 2022 |
| Last updated in NPPES | March 4, 2022 |
| Certification date | March 4, 2022 |
| Mailing address | 1620 S Elwood Ave Apt L3, Tulsa, OK 74119-4252 |
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