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General NPI Number Information
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NPI Number | 1659607455
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Entity Type | Organization
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Legal Business Name | JM CLEMENTE CO. LTD
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Dates
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Enumeration Date | 10/29/2009
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Last Update Date | 10/29/2009
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Provider Practice Location Address
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Address Line | 3100 NILES RD SE
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City | WARREN
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State | OH
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Zip | 44484-3276
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Country | US
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Telephone | 330-392-7069
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Fax | 330-392-7071
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Provider Business Mailing Address
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Address Line | 3100 NILES RD SE
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City | WARREN
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State | OH
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Zip | 44484-3276
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Country | US
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Telephone | 330-392-7069
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Fax | 330-392-7071
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. JOHN MARK CLEMENTE
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Credential |
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Telephone | 330-392-7069
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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