Healthcare Provider Details

I. General information

NPI: 1851396543
Provider Name (Legal Business Name): THOMAS J. CLAYTON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 08/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3230 STATE ROUTE 257
SENECA PA
16346-2434
US

IV. Provider business mailing address

PO BOX 406
SENECA PA
16346-0406
US

V. Phone/Fax

Practice location:
  • Phone: 814-677-3881
  • Fax: 814-677-0532
Mailing address:
  • Phone: 814-677-3881
  • Fax: 814-677-0532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-002999-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: