Healthcare Provider Details

I. General information

NPI: 1649101106
Provider Name (Legal Business Name): JULIETTE JACKY CLAVIER PT, DPT
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14057 US HIGHWAY 17 STE 230
HAMPSTEAD NC
28443-3999
US

IV. Provider business mailing address

14057 US HIGHWAY 17 STE 230
HAMPSTEAD NC
28443-3999
US

V. Phone/Fax

Practice location:
  • Phone: 910-821-3377
  • Fax:
Mailing address:
  • Phone: 910-821-3377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP24901
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: