Provider Demographics
NPI:1497052922
Name:MCCLURE, JOHN DAVID (PT, CLT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:DAVID
Last Name:MCCLURE
Suffix:
Gender:M
Credentials:PT, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 EASTON RD
Mailing Address - Street 2:
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-1202
Mailing Address - Country:US
Mailing Address - Phone:215-345-3251
Mailing Address - Fax:
Practice Address - Street 1:1660 EASTON RD
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-1202
Practice Address - Country:US
Practice Address - Phone:215-345-3251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017448225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist