Provider Demographics
NPI:1558825851
Name:MCLEAN, GILLIAN ASHLEY (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:GILLIAN
Middle Name:ASHLEY
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6048 S DURANGO DR STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-1781
Mailing Address - Country:US
Mailing Address - Phone:702-260-6238
Mailing Address - Fax:702-263-6530
Practice Address - Street 1:6048 S DURANGO DR STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-1781
Practice Address - Country:US
Practice Address - Phone:702-260-6238
Practice Address - Fax:702-263-6530
Is Sole Proprietor?:No
Enumeration Date:2019-01-31
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
NV4328225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist