Individual
MR. JON ERIC CLENNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
6391 PAYNE RD, TOBACCOVILLE, NC 27050-9646
(336) 983-5368
Mailing address
6391 PAYNE RD, TOBACCOVILLE, NC 27050-9646
(336) 983-5368
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
68908
NC
Other
Enumeration date
04/07/2010
Last updated
04/07/2010
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