Healthcare Provider Details

I. General information

NPI: 1275474082
Provider Name (Legal Business Name): BARCLAY VANCLIFF CHARLES-PIERRE ZUMBA B1 CERTIFICATE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 MAIN ST APT 330
MEDWAY MA
02053-1789
US

IV. Provider business mailing address

39 MAIN ST APT 330
MEDWAY MA
02053-1789
US

V. Phone/Fax

Practice location:
  • Phone: 781-720-4266
  • Fax: 127-020-3058
Mailing address:
  • Phone: 781-720-4266
  • Fax: 127-020-3058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: