Provider Demographics
NPI:1548405764
Name:J C CLEMENT INC.
Entity Type:Organization
Organization Name:J C CLEMENT INC.
Other - Org Name:SPECIAL TOUCH THERAPEUTIC MASSAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOY
Authorized Official - Middle Name:C
Authorized Official - Last Name:CLEMENT DERISE
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:337-480-1100
Mailing Address - Street 1:1737 W. SALE RD.
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605
Mailing Address - Country:US
Mailing Address - Phone:337-480-1100
Mailing Address - Fax:337-480-1174
Practice Address - Street 1:1737 W. SALE RD.
Practice Address - Street 2:SUITE 103
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605
Practice Address - Country:US
Practice Address - Phone:337-480-1100
Practice Address - Fax:337-480-1174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA0048174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty