Provider Demographics
NPI:1629416425
Name:MCCLAIN, CHRISTY ANNE (PHYSCIAL THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:CHRISTY
Middle Name:ANNE
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:PHYSCIAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 NE ADAMS DAIRY PKWY
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014-5450
Mailing Address - Country:US
Mailing Address - Phone:816-808-7910
Mailing Address - Fax:
Practice Address - Street 1:19000 E EASTLAND CENTER CT
Practice Address - Street 2:200
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-7022
Practice Address - Country:US
Practice Address - Phone:816-478-3326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001006560225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist