Individual
MRS. STACIE RACHELL CLEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
2 RIDGEVIEW DR, BARBOURSVILLE, WV 25504-9340
(304) 633-9706
Mailing address
2 RIDGEVIEW DR, BARBOURSVILLE, WV 25504-9340
(304) 633-9706
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT 001819
WV
Other
Enumeration date
01/01/2012
Last updated
01/01/2012
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