Provider Demographics
NPI:1043763501
Name:PIEZ, CLAYTON (PT)
Entity Type:Individual
Prefix:
First Name:CLAYTON
Middle Name:
Last Name:PIEZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 S UNIVERSITY DR
Mailing Address - Street 2:APT 107
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-1473
Mailing Address - Country:US
Mailing Address - Phone:813-598-4322
Mailing Address - Fax:
Practice Address - Street 1:3111 W BOYNTON BEACH BLVD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-4613
Practice Address - Country:US
Practice Address - Phone:561-742-3283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-01
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT316582251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic