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Individual

PROF. CAROL DENISE MCCLELLAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5535 HIGHLAND TRACE CT, WINSTON SALEM, NC 27105-1760
(336) 926-1643
Mailing address
5535 HIGHLAND TRACE CT, WINSTON SALEM, NC 27105-1760
(336) 926-1643

Taxonomy

Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
10454
NC

Other

Enumeration date
04/21/2010
Last updated
04/21/2010
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