Organization
OLD STAGE EYE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN KEVIN CLEMENT O.D. (OWNER)
(423) 639-8856
Entity
Organization
Contact information
Practice address
15 OLD STAGE RD, SUITE A, GREENEVILLE, TN 37745-3117
(423) 639-8856
(423) 639-8227
Mailing address
15 OLD STAGE RD, SUITE A, GREENEVILLE, TN 37745-3117
(423) 639-8856
(423) 639-8227
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODT 1457
TN
Other
Enumeration date
05/29/2009
Last updated
05/29/2009
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