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General NPI Number Information
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NPI Number | 1609756436
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Entity Type | Organization
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Legal Business Name | MCCLELLAN THERAPY PC
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 904 E 20TH ST STE A
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City | FARMINGTON
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State | NM
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Zip | 87401-4281
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Country | US
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Telephone | 505-459-3788
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Fax |
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Provider Business Mailing Address
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Address Line | 5608 FAIRWAY DR
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City | FARMINGTON
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State | NM
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Zip | 87402-5027
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Country | US
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Telephone | 505-459-3788
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAN MCCLELLAN
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Credential | PT, DPT
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Telephone | 505-459-3788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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