Individual
JAMES CLAYTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1611 E 32ND ST, MINNEAPOLIS, MN 55407-1828
(651) 795-9256
Mailing address
1611 E 32ND ST, MINNEAPOLIS, MN 55407-1828
(651) 795-9256
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
253Z00000X
In Home Supportive Care Agency
—
—
347C00000X
Private Vehicle
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245879
SHYNE BRIGHT SERVICES
—
05
—
47551326
—
MN
Enumeration date
06/13/2019
Last updated
08/20/2019
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