Individual
CLEMENT EKELEME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4609 LAVISTA CT # B, RALEIGH, NC 27616-5260
(919) 523-9668
Mailing address
4609 LAVISTA CT # B, RALEIGH, NC 27616-5260
(919) 523-9668
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
34687881
NC
Other
Enumeration date
03/03/2022
Last updated
03/03/2022
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