Stacey Lee Clemmons

NPI #1942892070 in Douglas, Georgia

Provider Information

NPI Number: 1942892070
Entity Type: Individual
Name: Stacey Lee Clemmons
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Contractor
Enumeration Date: Feb 10, 2021
Last Updated: Feb 10, 2021

Practice Location

Address: 412 PHILLIPS ST W
City: Douglas
State: Georgia
ZIP Code: 31533-2537
Phone: (912) 292-5088

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X	Primary

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