MEDICARE: JAY DAVID CLAYPOOL PT

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	225100000X	Physical Therapist	5501006952	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	30439	OTHER	MI	BLUE CROSS

General Provider Information

NPI Number	:	1992816961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAY DAVID CLAYPOOL PT

Provider Business Mailing Address
First Line	:	2001 BUTTERFIELD RD STE 1600
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1211
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1429 FLUSHING RD
Second Line	:	SUITE A
City	:	FLUSHING
State	:	MI
Zip	:	48433-2228
Country	:	US
Telephone Number	:	810-487-9128
Fax Number	:	810-487-9178

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	02/10/2025

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Directions to “ JAY DAVID CLAYPOOL PT” Practice Location

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