Individual
BARRET CLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
736 CAMBRIDGE ST, BRIGHTON, MA 02135-2907
(617) 789-3000
Mailing address
736 CAMBRIDGE ST, BRIGHTON, MA 02135-2907
(617) 789-3000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA5834
MA
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LICENSE NUMBER
PA5834
MA
Enumeration date
11/04/2016
Last updated
12/13/2018
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