MEDICARE: JOLEE R CLEMENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	2023033319	MO

General Provider Information

NPI Number	:	1609621564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOLEE R CLEMENT

Provider Business Mailing Address
First Line	:	2036 N GILBERT RD STE 7
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85203-2123
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1628 E SOUTHERN AVE
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-5782
Country	:	US
Telephone Number	:	480-590-0006
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2024
Last Update Date	:	04/23/2024

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Directions to “ JOLEE R CLEMENT ” Practice Location

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