Individual
CLYDE COPELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5465 SCENIC HTS, MANCHESTER, GA 31816
(706) 846-5410
Mailing address
5465 SCENIC HTS, MANCHESTER, GA 31816-6839
(706) 846-5410
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
GA
Other
Enumeration date
06/18/2012
Last updated
06/18/2012
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