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Individual

JENNIFER CLEMENT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CFM

Contact information

Practice address
142 ROXBORO RD, OXFORD, NC 27565-2642
(919) 693-2260
(919) 693-7368
Mailing address
142 ROXBORO RD, OXFORD, NC 27565-2642

Taxonomy

Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
Primary
CFM02010
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7704687
NC
Enumeration date
05/16/2011
Last updated
05/16/2011
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