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NPI Code Detail

MEDICARE: MARY MACLENNAN

MEDICARE: MARY MACLENNAN
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1003906736
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY MACLENNAN
Provider Business Mailing Address
First Line : 605 S PATTERSON BLVD
Second Line :
City : DAYTON
State : OH
Zip : 45402-2649
Country : US
Telephone Number : 937-395-4600
Fax Number : 937-395-4610
Provider Business Practice Location Address
First Line : 605 S PATTERSON BLVD
Second Line :
City : DAYTON
State : OH
Zip : 45402-2649
Country : US
Telephone Number : 937-395-4600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2006
Last Update Date : 04/23/2020

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Directions to “ MARY MACLENNAN ” Practice Location

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