Provider Demographics
NPI:1497820104
Name:MCCLELLAND, ROBERT RION (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:RION
Last Name:MCCLELLAND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1592 MARS HILL RD STE B
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-4890
Mailing Address - Country:US
Mailing Address - Phone:715-441-1193
Mailing Address - Fax:
Practice Address - Street 1:1592 MARS HILL RD STE B
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-4890
Practice Address - Country:US
Practice Address - Phone:715-441-1193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006421111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38962100Medicaid
WI38962100Medicaid