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NPI Code Detail

MEDICARE: KENA MCCLURE

MEDICARE: KENA MCCLURE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist18716AZ

General Provider Information

NPI Number : 1467296079
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENA MCCLURE
Provider Business Mailing Address
First Line : 8707 E WINDSOR AVE
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85257-1835
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11209 N TATUM BLVD STE 160
Second Line :
City : PHOENIX
State : AZ
Zip : 85028-3092
Country : US
Telephone Number : 480-285-2180
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2024
Last Update Date : 06/20/2024

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Directions to “ KENA MCCLURE ” Practice Location

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