Provider Demographics
NPI:1124641501
Name:MCCORD, JOHN
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:MCCORD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ENGLISH MEADOWS
Mailing Address - Street 2:1220 CROZET AVE
Mailing Address - City:CROZET
Mailing Address - State:VA
Mailing Address - Zip Code:22901
Mailing Address - Country:US
Mailing Address - Phone:434-823-4307
Mailing Address - Fax:
Practice Address - Street 1:ENGLISH MEADOWS
Practice Address - Street 2:1220 CROZET AVE
Practice Address - City:CROZET
Practice Address - State:VA
Practice Address - Zip Code:22901
Practice Address - Country:US
Practice Address - Phone:434-823-4307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202006892235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist