Individual
COBURN SHELL CLEMENTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1600 WESTBROOK AVE, RICHMOND, VA 23227-3337
(804) 551-2310
Mailing address
1600 WESTBROOK AVE, RICHMOND, VA 23227-3337
(804) 551-2310
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305211455
VA
Other
Enumeration date
06/01/2022
Last updated
06/01/2022
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