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General NPI Number Information
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NPI Number | 1770704462
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Entity Type | Individual
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Provider Name | JAY M MCCLOY ATC
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Gender | Male
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 10/15/2016
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Provider Practice Location Address
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Address Line | 1408 WALKER AVE 136 COLEMAN BUILDING
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City | GREENSBORO
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State | NC
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Zip | 27412-5020
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Country | US
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Telephone | 336-334-5925
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Fax | 336-256-0407
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Provider Business Mailing Address
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Address Line | UNIVERSITY OF NORTH CAROLINA AT GREENSBORO PO BOX 26168
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City | GREENSBORO
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State | NC
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Zip | 27402
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Country | US
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Telephone | 336-334-5925
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Fax | 336-256-0407
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 1633
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License Number State | NC
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