Provider Demographics
NPI:1184276073
Name:MASTERS, WILLIAM CLAYTON (PTA)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CLAYTON
Last Name:MASTERS
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 SEVEN MILE FERRY RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-8504
Mailing Address - Country:US
Mailing Address - Phone:931-263-2257
Mailing Address - Fax:
Practice Address - Street 1:812 N CHARLOTTE ST
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-1009
Practice Address - Country:US
Practice Address - Phone:615-446-8046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7076225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant