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General NPI Number Information
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NPI Number | 1952079907
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Entity Type | Individual
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Provider Name | CLAYTON MCVAY JR. PT, DPT, LAT, ATC
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Gender | Male
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Dates
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Enumeration Date | 09/03/2021
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 609 S HOWARD AVE STE 102
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City | TAMPA
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State | FL
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Zip | 33606-2412
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Country | US
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Telephone | 334-341-9015
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Fax |
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Provider Business Mailing Address
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Address Line | 3855 SWAMP LILY CT
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City | LUTZ
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State | FL
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Zip | 33559-7005
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Country | US
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Telephone | 334-341-9015
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Fax |
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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 | 2574
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 41919
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License Number State | FL
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