Healthcare Provider Details

I. General information

NPI: 1710138722
Provider Name (Legal Business Name): HENRY ARTHUR MCCLEARY D.C., C.S.C.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2008
Last Update Date: 09/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 EISENHOWER AVE., # 200
ALEXANDRIA VA
22314
US

IV. Provider business mailing address

16 CARROLLTON RD
STERLING VA
20165-5627
US

V. Phone/Fax

Practice location:
  • Phone: 855-862-3935
  • Fax: 703-444-4384
Mailing address:
  • Phone: 703-463-4644
  • Fax: 703-444-4384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number0877
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: