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Individual

WILLIAM CLOUGHLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
1160 HOSPITAL RD STE 100, NEW ROADS, LA 70760-2633
(225) 638-4455
(225) 208-6172
Mailing address
1160 HOSPITAL RD STE 100, NEW ROADS, LA 70760-2633
(225) 638-4455
(225) 208-6172

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
02225R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02225R
PHYSICAL THERAPY LICENSE
LA
Enumeration date
06/04/2019
Last updated
06/04/2019
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