Provider Demographics
NPI:1659523454
Name:MCCLURE, CHRISTOPHER PATRICK (PTA)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:PATRICK
Last Name:MCCLURE
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2593 HUDSON DR
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-2969
Mailing Address - Country:US
Mailing Address - Phone:724-431-7785
Mailing Address - Fax:
Practice Address - Street 1:45 CHART RD
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-2821
Practice Address - Country:US
Practice Address - Phone:330-928-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-13
Last Update Date:2008-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH06484225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant