Provider Demographics
NPI:1841656618
Name:ARDOIN, CLAY (DPT)
Entity type:Individual
Prefix:
First Name:CLAY
Middle Name:
Last Name:ARDOIN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 HOPSON RD
Mailing Address - Street 2:
Mailing Address - City:DOLGEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13329-2904
Mailing Address - Country:US
Mailing Address - Phone:315-717-5510
Mailing Address - Fax:
Practice Address - Street 1:4610 SWEETWATER BLVD
Practice Address - Street 2:#120
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3152
Practice Address - Country:US
Practice Address - Phone:315-717-5510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-11
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251C2600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistCardiopulmonary