Provider Demographics
NPI:1215663158
Name:MCLEAN, TERRY
Entity type:Individual
Prefix:MRS
First Name:TERRY
Middle Name:
Last Name:MCLEAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:649 SUNNY POND LN
Mailing Address - Street 2:
Mailing Address - City:AYNOR
Mailing Address - State:SC
Mailing Address - Zip Code:29511-4690
Mailing Address - Country:US
Mailing Address - Phone:843-605-1608
Mailing Address - Fax:
Practice Address - Street 1:3341 BROAD ST
Practice Address - Street 2:
Practice Address - City:LORIS
Practice Address - State:SC
Practice Address - Zip Code:29569-3019
Practice Address - Country:US
Practice Address - Phone:843-605-1608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-25
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health