MEDICARE: DR. MICHAEL BRIAN CLAY JR. D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NS0005X	Sports Physician Chiropractor	1897	MA

General Provider Information

NPI Number	:	1023080793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL BRIAN CLAY JR. D.C.

Provider Business Mailing Address
First Line	:	3200 VINE ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45220-2213
Country	:	US
Telephone Number	:	910-520-4345
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 VINE ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45220-2213
Country	:	US
Telephone Number	:	910-520-4345
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	06/07/2023

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