Provider Demographics
NPI:1124442090
Name:MCCLARY, MEGAN CHRISTINE (DPT)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:CHRISTINE
Last Name:MCCLARY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:208 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:PA
Mailing Address - Zip Code:18444-9135
Mailing Address - Country:US
Mailing Address - Phone:570-842-9323
Mailing Address - Fax:570-842-9362
Practice Address - Street 1:24569 ROUTE 6
Practice Address - Street 2:SUITE C
Practice Address - City:TOWANDA
Practice Address - State:PA
Practice Address - Zip Code:18848-8254
Practice Address - Country:US
Practice Address - Phone:570-265-1111
Practice Address - Fax:570-265-7134
Is Sole Proprietor?:No
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT023419225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist