Provider Demographics
NPI:1255809646
Name:CLOUGH, MARGARET (DC)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:CLOUGH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 E DRAKE RD APT N08
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-4622
Mailing Address - Country:US
Mailing Address - Phone:330-604-7804
Mailing Address - Fax:
Practice Address - Street 1:1226 W ASH ST UNIT A
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-4657
Practice Address - Country:US
Practice Address - Phone:970-460-0772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-05
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0007910111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty