Individual
MS. TINA MARIE CLEMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
302 S TENNESSEE AVE, MARTINSBURG, WV 25401-2259
(304) 262-2928
Mailing address
302 S TENNESSEE AVE, MARTINSBURG, WV 25401-2259
(304) 262-2928
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
000108
WV
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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