Provider Demographics
NPI:1750652293
Name:MCCLAIN, ELIZABETH (DC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:MCCLAIN
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 1:409 1/2 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-5409
Mailing Address - Country:US
Mailing Address - Phone:765-969-5891
Mailing Address - Fax:
Practice Address - Street 1:408 S 14TH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-6403
Practice Address - Country:US
Practice Address - Phone:765-969-5891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-13
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002622A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor