Provider Demographics
NPI:1306181425
Name:TUTTLE, CLAYTON RYAN (BS)
Entity type:Individual
Prefix:
First Name:CLAYTON
Middle Name:RYAN
Last Name:TUTTLE
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1481 W WARM SPRINGS RD # R
Mailing Address - Street 2:#129
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-7633
Mailing Address - Country:US
Mailing Address - Phone:702-547-0201
Mailing Address - Fax:702-944-7846
Practice Address - Street 1:1481 W WARM SPRINGS RD # R
Practice Address - Street 2:#129
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-7633
Practice Address - Country:US
Practice Address - Phone:702-547-0201
Practice Address - Fax:702-944-7846
Is Sole Proprietor?:No
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor