Individual
ELLEN CLEMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
731 POLO RD, COLUMBIA, SC 29223-4462
(803) 788-8655
Mailing address
942 BROOKFIELD DR, WEST COLUMBIA, SC 29172-2014
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3855
SC
Other
Enumeration date
03/11/2014
Last updated
03/11/2014
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