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General NPI Number Information
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NPI Number | 1003443359
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Entity Type | Organization
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Legal Business Name | HENRY A MCCLEARY DC LLC
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Dates
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Enumeration Date | 03/26/2020
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Last Update Date | 05/18/2021
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Provider Practice Location Address
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Address Line | 2241C TACKETTS MILL DR
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City | WOODBRIDGE
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State | VA
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Zip | 22192-3028
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Country | US
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Telephone | 703-463-4644
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Fax | 855-552-3776
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Provider Business Mailing Address
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Address Line | 2241C TACKETTS MILL DR
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City | WOODBRIDGE
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State | VA
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Zip | 22192-3028
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Country | US
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Telephone | 703-463-4644
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Fax | 855-552-3776
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Authorized Official
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Title or Position | OWNER
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Name | DR. HENRY A MCCLEARY
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Credential | DC
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Telephone | 703-463-4644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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