Most Relevant Information
Provider Data
| NPI Number: | 1003370966 |
| Provider Name: | CLIFTON AUGUSTUS WILLOUGHBY PTA/ATC |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | PTA010757 |
Most Important Dates
| Enumeration Date: | 01/24/2019 |
| Last Updated: | 01/24/2019 |
Provider Practice Location
6210 CLEVES WARSAW PIKE
CINCINNATI
OH
452334510
Practice Location Phone/Fax
| Phone: | 5133092825 |
| Fax: |
Provider Mailing Location
6210 CLEVES WARSAW PIKE
CINCINNATI
OH
452334512
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |