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NPI 1598326514

NPI 1598326514 : ANDREW MCCLURE PT : CARMEL, IN

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General NPI Number Information
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    NPI Number           |    1598326514
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    Entity Type          |    Individual 
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    Provider Name        |    ANDREW MCCLURE PT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/21/2019
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    Last Update Date     |    11/17/2022
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Provider Practice Location Address
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    Address Line         |    820 CITY CENTER DR 
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    City                 |    CARMEL
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    State                |    IN
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    Zip                  |    46032-3828
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    Country              |    US
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    Telephone            |    317-750-0626
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6626 E 75TH ST STE 500 
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    City                 |    INDIANAPOLIS
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    State                |    IN
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    Zip                  |    46250-2890
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    Country              |    US
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    Telephone            |    
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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       |    05011109A
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    License Number State |    IN
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