Provider Demographics
NPI:1245474618
Name:CLEMENTS WELLNESS CENTER INC
Entity type:Organization
Organization Name:CLEMENTS WELLNESS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HERMAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:CLEMENTS
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:501-279-1547
Mailing Address - Street 1:403 S POPLAR ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-6017
Mailing Address - Country:US
Mailing Address - Phone:501-279-7600
Mailing Address - Fax:501-279-7605
Practice Address - Street 1:403 S POPLAR ST
Practice Address - Street 2:SUITE C
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-6017
Practice Address - Country:US
Practice Address - Phone:501-279-7600
Practice Address - Fax:501-279-7605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-28
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty