Provider Demographics
NPI:1538651997
Name:MCCLELLAN, WILLIAM M (DPT)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:M
Last Name:MCCLELLAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 CRESCENT CENTRE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-7285
Mailing Address - Country:US
Mailing Address - Phone:615-416-0199
Mailing Address - Fax:
Practice Address - Street 1:5541 GROVE BLVD STE C2
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-4600
Practice Address - Country:US
Practice Address - Phone:205-277-6870
Practice Address - Fax:205-277-6871
Is Sole Proprietor?:No
Enumeration Date:2018-06-01
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-0936225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist