Individual
COLENE CLAYBORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
3600 GRANT AVE, PHILADELPHIA, PA 19114-2630
(215) 677-0400
(215) 971-1837
Mailing address
3600 GRANT AVE, PHILADELPHIA, PA 19114-2630
(215) 677-0400
(215) 971-1837
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT017034
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1634362
HIGHMARK
PA
Enumeration date
08/11/2006
Last updated
10/15/2007
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