Provider Demographics
NPI:1629190533
Name:D A MACLENNAN DC PA
Entity Type:Organization
Organization Name:D A MACLENNAN DC PA
Other - Org Name:MACLENNAN CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:MACLENNAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:979-245-7374
Mailing Address - Street 1:2009 13TH ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414-4339
Mailing Address - Country:US
Mailing Address - Phone:979-245-7374
Mailing Address - Fax:979-323-7460
Practice Address - Street 1:2009 13TH ST
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-4339
Practice Address - Country:US
Practice Address - Phone:979-245-7374
Practice Address - Fax:979-323-7460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6381111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty