Provider Demographics
NPI:1699550160
Name:MCCLAIN, JAKOB (PT)
Entity type:Individual
Prefix:
First Name:JAKOB
Middle Name:
Last Name:MCCLAIN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3360 NE LOOP 286 STE 101
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-3438
Mailing Address - Country:US
Mailing Address - Phone:903-669-3535
Mailing Address - Fax:
Practice Address - Street 1:3360 NE LOOP 286 STE 101
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-3438
Practice Address - Country:US
Practice Address - Phone:903-669-3535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist