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General NPI Number Information
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NPI Number | 1912297318
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Entity Type | Organization
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Legal Business Name | MCCLEARY CHIROPRACTIC CLINIC PC
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Dates
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Enumeration Date | 04/19/2011
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Last Update Date | 04/19/2011
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Provider Practice Location Address
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Address Line | 8601 N KENTUCKY AVE SUITE I
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City | EVANSVILLE
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State | IN
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Zip | 47725-6371
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Country | US
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Telephone | 812-491-6772
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Fax |
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Provider Business Mailing Address
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Address Line | 1831 SCHENK RD
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City | EVANSVILLE
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State | IN
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Zip | 47720-7188
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Country | US
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Telephone | 812-626-6556
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Fax | 812-626-6556
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN A MCCLEARY
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Credential | DC
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Telephone | 812-626-6556
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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 | 776
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License Number State | IN
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