Individual
KIM MCCLENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
859 CHAPMAN CIR, STONE MOUNTAIN, GA 30088-2553
(404) 201-9075
Mailing address
859 CHAPMAN CIR, STONE MOUNTAIN, GA 30088-2553
(404) 201-9075
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
02/02/2018
Last updated
02/02/2018
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