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Individual

CLAYTON MARK GRAVATT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
310 CHESTNUT ST, JOHNSON, NE 68378-8304
(402) 250-6042
Mailing address
310 CHESTNUT ST, JOHNSON, NE 68378-8304
(402) 250-6042

Taxonomy

Speciality
Code
Description
License number
State
372500000X
Chore Provider
372600000X
Adult Companion
3747P1801X
Personal Care Attendant
Primary

Other

Enumeration date
04/30/2025
Last updated
04/30/2025
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