Individual
MS. THERESA LEE CLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
402 MAIN ST., VAN BUREN, MO 63965
(573) 323-4853
(573) 323-4465
Mailing address
696 CARTER ROUTE M, VAN BUREN, MO 63965-7014
(573) 323-2171
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
475-1
MO
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
08/02/2006
Last updated
01/28/2019
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