Individual
MELONIE CLEMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
60 OLD HIGHWAY 5 S, ELLIJAY, GA 30540-5436
(706) 276-2000
(706) 276-2080
Mailing address
64 WALNUT MOUNTAIN CT, ELLIJAY, GA 30536-2674
(706) 635-3132
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT001550
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
910061011A
—
GA
Enumeration date
04/10/2007
Last updated
05/25/2021
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