| Doctor Name: | MR. JAY SCOTT CLOUTIER |
| NPI Number: | 1245210715 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT, SCS, ATC |
| License Number: | 579 |
| Business Practice Address: | 66 Mdg/sgo 90 Vandeberg Ave Hanscom Afb, MA - 01731 |
| Business Phone Number: | 7813774702 |
| Business Fax Number: | |
| Mailing Address: | 90 Vandenberg Dr, HANSCOM AFB |
| State: | MA |
| Postal Code: | 017312104 |
| Phone Number: | 7813774702 |
| Fax Number: | |
| NPI Enumeration Date: | 01/19/2006 |
| NPI Last Update Date: | 12/14/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251S0007X |
| License Number: | 579 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Sports |
| Taxonomy Definition: | |