Provider Demographics
NPI:1427130525
Name:MCLEAN, JULIE LYNN (DC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:LYNN
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:LYNN
Other - Last Name:KAHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:150 ELDEN ST
Mailing Address - Street 2:243
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4861
Mailing Address - Country:US
Mailing Address - Phone:703-481-1808
Mailing Address - Fax:703-481-1806
Practice Address - Street 1:150 ELDEN ST
Practice Address - Street 2:243
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4861
Practice Address - Country:US
Practice Address - Phone:703-481-1808
Practice Address - Fax:703-481-1806
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555877111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA165547Medicare UPIN