Individual
JENNIFER MARIE CLEMENTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
330 ROBIN HOOD LN, GILLETT, WI 54124-9201
(920) 855-2136
Mailing address
820 MADISON ST, OCONTO, WI 54153-1611
(920) 604-2424
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1672-19
WI
Other
Enumeration date
12/08/2011
Last updated
12/08/2011
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