Provider Demographics
NPI:1386091205
Name:MCCLURE, BRANDY (OT)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3628 SCOTLAND MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17202-7414
Mailing Address - Country:US
Mailing Address - Phone:717-552-2788
Mailing Address - Fax:717-552-2761
Practice Address - Street 1:3628 SCOTLAND MAIN ST
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17202-7414
Practice Address - Country:US
Practice Address - Phone:717-552-2788
Practice Address - Fax:717-552-2761
Is Sole Proprietor?:No
Enumeration Date:2016-05-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC010654225X00000X, 225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation