Healthcare Provider Details

I. General information

NPI: 1568162568
Provider Name (Legal Business Name): CLAYTON CLEMENS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2023
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 ESTERLY ST
EAST JORDAN MI
49727-5112
US

IV. Provider business mailing address

8196 CARSON AVE
CHARLEVOIX MI
49720-2043
US

V. Phone/Fax

Practice location:
  • Phone: 231-430-1556
  • Fax:
Mailing address:
  • Phone: 231-430-1556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301401401
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: