Clark, Bradley Dewayne

Clark, Bradley Dewayne is an individual health care provider with primary practice located at 252 W 17Th Pl , Tulsa OK 74119-4654. He recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as his primary health care specialty. Clark, Bradley Dewayne can be contacted via phone (918) 200-9065.

Contact Information

Primary practice address
252 W 17Th Pl Tulsa OK 74119-4654
Phone: (918) 200-9065
Fax: (918) 585-9543
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X

Profile Details

NPI number 1457008955
LBN Legal business name Clark, Bradley Dewayne
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 4th, 2022
Last updated Mar 4th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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