Provider Demographics
NPI:1699250563
Name:MCLANE, AMY CHRISTINE (DC)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:CHRISTINE
Last Name:MCLANE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E REDLANDS BLVD STE 184
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4700
Mailing Address - Country:US
Mailing Address - Phone:909-793-5603
Mailing Address - Fax:
Practice Address - Street 1:101 E REDLANDS BLVD STE 184
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4700
Practice Address - Country:US
Practice Address - Phone:909-793-5603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34158111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor