Provider Demographics
NPI:1730268822
Name:PETROPOULOS, CLAYTON J (DC)
Entity type:Individual
Prefix:DR
First Name:CLAYTON
Middle Name:J
Last Name:PETROPOULOS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:CLAYTON
Other - Middle Name:
Other - Last Name:PETROS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:11 HEATHER LOCH
Mailing Address - Street 2:
Mailing Address - City:NORTH YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04097-6431
Mailing Address - Country:US
Mailing Address - Phone:207-523-0507
Mailing Address - Fax:
Practice Address - Street 1:49 TOPSHAM FAIR MALL RD
Practice Address - Street 2:SUITE 25
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-1734
Practice Address - Country:US
Practice Address - Phone:207-406-4795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1668111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor