Provider Demographics
NPI:1154568624
Name:MCCLAIN, JOHN PAUL (RPT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:PAUL
Last Name:MCCLAIN
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:789 SAINT ALBANS DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-1522
Mailing Address - Country:US
Mailing Address - Phone:954-562-6610
Mailing Address - Fax:561-393-3708
Practice Address - Street 1:789 SAINT ALBANS DR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-1522
Practice Address - Country:US
Practice Address - Phone:954-562-6610
Practice Address - Fax:561-393-3708
Is Sole Proprietor?:No
Enumeration Date:2009-01-20
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0017902225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist