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General NPI Number Information
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NPI Number | 1609573369
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Entity Type | Organization
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Legal Business Name | CLAVON CLINIC, LLC
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Dates
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Enumeration Date | 02/13/2023
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 4915 SAINT ELMO AVE STE 300
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City | BETHESDA
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State | MD
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Zip | 20814-6077
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Country | US
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Telephone | 240-970-1780
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Fax | 240-970-1781
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Provider Business Mailing Address
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Address Line | 4915 SAINT ELMO AVE STE 300
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City | BETHESDA
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State | MD
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Zip | 20814-6077
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Country | US
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Telephone | 240-970-1780
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Fax | 240-970-1781
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Authorized Official
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Title or Position | ORTHOTIST
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Name | MR. KELVIN SMITH JR.
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Credential | CO
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Telephone | 240-750-4599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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