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General NPI Number Information
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NPI Number | 1235284787
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Entity Type | Organization
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Legal Business Name | MCCLELLAN CHIROPRACTIC CENTER, PSC
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1140 BARNES MILL RD
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City | RICHMOND
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State | KY
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Zip | 40475-8730
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Country | US
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Telephone | 859-623-3780
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Fax | 859-623-8377
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Provider Business Mailing Address
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Address Line | 1140 BARNES MILL RD
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City | RICHMOND
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State | KY
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Zip | 40475-8730
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Country | US
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Telephone | 859-623-3780
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Fax | 859-623-8377
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. JOHN DALLAS MCCLELLAN
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Credential | D.C.
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Telephone | 859-623-3780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3790
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License Number State | KY
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