Provider Demographics
NPI:1477886547
Name:MCCLURE, BECCA L (PT)
Entity Type:Individual
Prefix:
First Name:BECCA
Middle Name:L
Last Name:MCCLURE
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 1:910 BLACKFORD ST
Mailing Address - Street 2:ATTN: CHILDRENS THERAPY
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-1405
Mailing Address - Country:US
Mailing Address - Phone:423-778-2595
Mailing Address - Fax:423-778-2275
Practice Address - Street 1:910 BLACKFORD ST
Practice Address - Street 2:ATTN: CHILDREN'S THERAPY
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-1405
Practice Address - Country:US
Practice Address - Phone:423-778-2595
Practice Address - Fax:423-778-2275
Is Sole Proprietor?:No
Enumeration Date:2009-09-08
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6519225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist