Provider Demographics
NPI:1912297318
Name:MCCLEARY CHIROPRACTIC CLINIC PC
Entity type:Organization
Organization Name:MCCLEARY CHIROPRACTIC CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCCLEARY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:812-626-6556
Mailing Address - Street 1:1831 SCHENK RD
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47720-7188
Mailing Address - Country:US
Mailing Address - Phone:812-626-6556
Mailing Address - Fax:812-626-6556
Practice Address - Street 1:8601 N KENTUCKY AVE
Practice Address - Street 2:SUITE I
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47725-6371
Practice Address - Country:US
Practice Address - Phone:812-491-6772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN776111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty