Provider Demographics
NPI:1730262171
Name:MCLEAN, JOSEPH ANTHONY (PT)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ANTHONY
Last Name:MCLEAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39930 SIERRA WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:OAKHURST
Mailing Address - State:CA
Mailing Address - Zip Code:93644
Mailing Address - Country:US
Mailing Address - Phone:559-683-0974
Mailing Address - Fax:559-683-0973
Practice Address - Street 1:39930 SIERRA WAY
Practice Address - Street 2:SUITE A
Practice Address - City:OAKHURST
Practice Address - State:CA
Practice Address - Zip Code:93644
Practice Address - Country:US
Practice Address - Phone:559-683-0974
Practice Address - Fax:559-683-0973
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT17912225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT17912OtherPT BOARD OF CA
CAPT17912OtherPT BOARD OF CA