Organization
CLEMENTS PROFESSIONAL ASSOCIATION PINE MOUNTAIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA D CLEMENTS MD (VP SEC TRES AND MD)
(706) 663-2574
Entity
Organization
Contact information
Practice address
211 EAST BROAD ST, PINE MOUNTAIN, GA 31822-0516
(706) 663-2574
(706) 663-5954
Mailing address
PO BOX 516, PINE MOUNTAIN, GA 31822-0516
(706) 663-2574
(706) 663-5954
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
10/01/2007
Last updated
01/24/2013
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