Provider Demographics
NPI:1902963366
Name:MCCLURE, ROBERT L (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:MCCLURE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 WISCONSIN AVE NW
Mailing Address - Street 2:SUITE 251
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-4119
Mailing Address - Country:US
Mailing Address - Phone:202-362-0900
Mailing Address - Fax:
Practice Address - Street 1:2950 DALE BLVD
Practice Address - Street 2:
Practice Address - City:DALE CITY
Practice Address - State:VA
Practice Address - Zip Code:22193-1120
Practice Address - Country:US
Practice Address - Phone:202-362-0900
Practice Address - Fax:202-362-1391
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556493111N00000X
DCCH030069111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation