Provider Demographics
NPI:1013220763
Name:CLAYTON, TIMOTHY JASON (DC)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JASON
Last Name:CLAYTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 W PLANK RD
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-3016
Mailing Address - Country:US
Mailing Address - Phone:814-941-5353
Mailing Address - Fax:814-283-0066
Practice Address - Street 1:332 W PLANK RD
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-3016
Practice Address - Country:US
Practice Address - Phone:814-941-5353
Practice Address - Fax:814-283-0066
Is Sole Proprietor?:No
Enumeration Date:2010-07-23
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010304111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor