Individual
CLAYTON FAIRCLOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC, LAT
Contact information
Practice address
208 IVEY DR SW, MILLEDGEVILLE, GA 31061-3760
(912) 687-1080
Mailing address
208 IVEY DR SW, MILLEDGEVILLE, GA 31061-3760
(912) 687-1080
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002924
GA
Other
Enumeration date
09/22/2016
Last updated
09/22/2016
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