Provider Demographics
NPI:1679245583
Name:CLAMPITT, JOSHUA (DC)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:CLAMPITT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 S WALKER ST STE B
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47403-2149
Mailing Address - Country:US
Mailing Address - Phone:812-269-2414
Mailing Address - Fax:
Practice Address - Street 1:340 S WALKER ST STE B
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-2149
Practice Address - Country:US
Practice Address - Phone:812-269-2414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003082A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor