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General NPI Number Information
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NPI Number | 1649804410
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Entity Type | Organization
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Legal Business Name | CLAYTON PHYSICAL THERAPY AND WELLNESS, PLLC
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Dates
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Enumeration Date | 03/02/2020
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Last Update Date | 03/02/2020
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Provider Practice Location Address
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Address Line | 5775 BULLARD RD
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City | FENTON
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State | MI
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Zip | 48430-9431
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Country | US
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Telephone | 810-354-5230
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Fax |
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Provider Business Mailing Address
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Address Line | 17195 SILVER PKWY # 122
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City | FENTON
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State | MI
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Zip | 48430-3426
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/ PHYSICAL THERAPIST
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Name | JAMIE CLAYTON
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Credential | PT
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Telephone | 248-425-9627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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