Provider Demographics
NPI:1417099839
Name:MACLAUCHLIN, JANET (PT)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:MACLAUCHLIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 WESTOVER AVE SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24015-5215
Mailing Address - Country:US
Mailing Address - Phone:540-740-0842
Mailing Address - Fax:540-206-2776
Practice Address - Street 1:1629 WESTOVER AVE SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24015-5215
Practice Address - Country:US
Practice Address - Phone:540-740-0842
Practice Address - Fax:540-206-2776
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305203214225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist