Individual
JACKSON DAVID CLOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2060 RHINO CROSSING, MILAN, TN 38358
(731) 613-2214
Mailing address
PO BOX 1004, MILAN, TN 38358-1004
(731) 613-2214
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12254
TN
Other
Enumeration date
06/28/2019
Last updated
06/28/2019
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