Individual
GEORGE CLOUD III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2701 CHESTNUT STATION CT, LOUISVILLE, KY 40299-6395
(800) 335-1060
Mailing address
3040 99TH ST, HIGHLAND, IN 46322-3345
(708) 420-6387
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06004967A
IN
225200000X
Physical Therapy Assistant
160.005886
IL
Other
Enumeration date
03/19/2015
Last updated
03/19/2015
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