Provider Demographics
NPI:1285998039
Name:MCCLEAF, DAVID MICHAEL (DPT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:MICHAEL
Last Name:MCCLEAF
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24850 OLD 41 RD STE 17
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-7024
Mailing Address - Country:US
Mailing Address - Phone:239-947-3900
Mailing Address - Fax:239-236-0647
Practice Address - Street 1:24850 OLD 41 RD STE 17
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-7024
Practice Address - Country:US
Practice Address - Phone:239-947-3900
Practice Address - Fax:239-236-0647
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT267592251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic