Individual provider · Type 1 NPI

Brandon Clark

Physical Therapy Assistant · Lakeland, FL

NPI number 1053285353 Active

Practice location

4725 US Highway 98 S Ste 101-102
Lakeland, FL 33812-4334

Call (863) 274-9700 Map

Mailing address

5901 E Fowler Ave Ste 100
Temple Terrace, FL 33617-2305

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000XPTA34319 (FL)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1053285353

Brandon Clark's National Provider Identifier is 1053285353, issued on Oct 1, 2025. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Lakeland, FL. The record was last updated on Oct 1, 2025.