Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic |
NPI | 1073266367 |
---|---|
Provider Name | Dr. Andrew Mcclure |
First Address | Center, CO 81125-0323 |
Second Address | Rifle, CO 81650-8510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2022 |
Last Update Date | 27/01/2022 |