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General NPI Number Information
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NPI Number | 1255171419
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Entity Type | Individual
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Provider Name | JUDY ANN MCCLANAHAN DPT
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Gender | Female
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Dates
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Enumeration Date | 05/27/2024
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Last Update Date | 05/27/2024
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Provider Practice Location Address
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Address Line | 2131 COLLEGE AVE
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City | BLUEFIELD
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State | VA
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Zip | 24605-2002
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Country | US
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Telephone | 276-352-4896
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 736
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City | NORTH TAZEWELL
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State | VA
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Zip | 24630-0736
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Country | US
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Telephone | 276-287-0608
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305204434
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License Number State | VA
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