Provider Information for 1336403724
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TROY CLAYTON PLMHP
Sex: Male
NPI: 1336403724
Last Updated: 2019-11-01
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1336403724 | ||||||||
| Enumeration Date | 2012-06-29 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 2245 KEARNEY, NE 68848-2245 United States Phone: 308-224-2240 | Fax: | ||||||||
| Primary Practice Address | 2315 W 39TH ST KEARNEY, NE 68845-8327 United States Phone: 308-832-6650 | Fax: | ||||||||
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