Organization
MOUNTAINSIDE PEDIATRIC AND ADOLESCENT CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTORIA L CLEMENTS DO (OWNER/PROVIDER)
(706) 982-2721
Entity
Organization
Contact information
Practice address
995 MAIN ST, ANDREWS, NC 28901-7087
(828) 321-3210
(828) 321-3211
Mailing address
995 MAIN ST, ANDREWS, NC 28901-7087
(828) 321-3210
(828) 321-3211
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
01/19/2021
Last updated
05/25/2021
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