Provider Demographics
NPI:1396192589
Name:BARTHELEMY, CLINTON (ATC)
Entity Type:Individual
Prefix:
First Name:CLINTON
Middle Name:
Last Name:BARTHELEMY
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5018 CAHABA RIVER RD
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-2317
Mailing Address - Country:US
Mailing Address - Phone:205-747-2710
Mailing Address - Fax:
Practice Address - Street 1:5018 CAHABA RIVER RD
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-2317
Practice Address - Country:US
Practice Address - Phone:205-747-2710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-18
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12312255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer