Provider Demographics
NPI:1649957184
Name:MCLEAN, EMILY ELISABETH (DPT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ELISABETH
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4339 WILDERNESS CT
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35213-2209
Mailing Address - Country:US
Mailing Address - Phone:205-790-5786
Mailing Address - Fax:
Practice Address - Street 1:4339 WILDERNESS CT
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35213-2209
Practice Address - Country:US
Practice Address - Phone:205-790-5786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH11368225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist