Provider Demographics
NPI:1427021336
Name:CLAYTON, JULIE
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:CLAYTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 THIRD ST
Mailing Address - Street 2:
Mailing Address - City:LAKE VIEW
Mailing Address - State:IA
Mailing Address - Zip Code:51450
Mailing Address - Country:US
Mailing Address - Phone:712-657-2225
Mailing Address - Fax:
Practice Address - Street 1:517 THIRD ST
Practice Address - Street 2:
Practice Address - City:LAKE VIEW
Practice Address - State:IA
Practice Address - Zip Code:51450
Practice Address - Country:US
Practice Address - Phone:712-657-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-10
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA06123111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA47254Medicare ID - Type Unspecified