Healthcare Provider Details

I. General information

NPI: 1336716786
Provider Name (Legal Business Name): THE CLAIRITY METHOD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2021
Last Update Date: 06/04/2021
Certification Date: 06/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11611 SAN VICENTE BLVD
LOS ANGELES CA
90049-5106
US

IV. Provider business mailing address

11611 SAN VICENTE BLVD
LOS ANGELES CA
90049-5106
US

V. Phone/Fax

Practice location:
  • Phone: 904-210-2713
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CLARENCE HOWARD
Title or Position: CEO
Credential:
Phone: 904-210-2713