Provider Demographics
NPI:1639183338
Name:MCLEAN, KRISTIE J (DC)
Entity Type:Individual
Prefix:DR
First Name:KRISTIE
Middle Name:J
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 DORCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02127-2154
Mailing Address - Country:US
Mailing Address - Phone:617-268-0333
Mailing Address - Fax:617-268-0445
Practice Address - Street 1:14 DORCHESTER ST STE 2
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127-2154
Practice Address - Country:US
Practice Address - Phone:617-268-0333
Practice Address - Fax:617-268-0445
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2563111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor