Individual
JOHN CLOUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MED,LAT, ATC
Contact information
Practice address
12038 STATE HIGHWAY 205, LAVON, TX 75166-1846
(972) 722-4875
Mailing address
12038 STATE HIGHWAY 205, LAVON, TX 75166-1846
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0633
TX
Other
Enumeration date
07/22/2016
Last updated
07/22/2016
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