NPI 1013383926 · live from the CMS NPI Registry
Clark Brainerd, PT
Physical Therapist in Massillon, OH. National Provider Identifier 1013383926, active.
NPI record
| NPI | 1013383926 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physical Therapist 225100000X |
| Practice location | 8722 Glenarden Cir Nw, Massillon, OH 44646 |
| Practice phone | 330-685-4384 |
| Mailing address | 3301 New Mexico Ave Nw, Suite 318, Washington, DC 20016 |
| Enumerated | August 14, 2015 |
| Last updated | November 16, 2015 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physical Therapist primary | 225100000X | PT871879 (DC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.