| Organization Name: | CLANTON ENTERPRISES, SERIES LLC |
| NPI Number: | 1023490091 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BARRY A CLANTON (OWNER/PHYSICIAN) |
| Mailing Address: | 75 S 200 E Suite 202 Provo |
| State: | UT US |
| Postal Code: | 846063146 |
| Phone Number: | 8013752207 |
| Fax Number: | 8013752307 |
| NPI Enumeration Date: | 06/25/2015 |
| NPI Last Update Date: | 06/25/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 7417572-1206 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |