Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 012039 | OH |
NPI | 1003042870 |
---|---|
Provider Name | Mrs. Melanie Anne Mcclain |
First Address | Columbus, OH 43220-3621 |
Second Address | Columbus, OH 43220-3621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2009 |
Last Update Date | 06/06/2009 |