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NPI Code Detail

MEDICARE: CHRISTINE CAROL CLEMENTS

MEDICARE: CHRISTINE CAROL CLEMENTS
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
1225X00000XOccupational Therapist
2225XH1200XHand Occupational Therapist5201001749MI

General Provider Information

NPI Number : 1710489141
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE CAROL CLEMENTS
Provider Business Mailing Address
First Line : 4901 TOWNE CENTRE RD STE 300
Second Line :
City : SAGINAW
State : MI
Zip : 48604-2889
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3901 BAY RD
Second Line :
City : SAGINAW
State : MI
Zip : 48603-2438
Country : US
Telephone Number : 989-498-5104
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2018
Last Update Date : 09/11/2023

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Directions to “ CHRISTINE CAROL CLEMENTS ” Practice Location

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