Provider Demographics
NPI:1841782448
Name:MCCLAIN, COURTNEY ALEXANDER (ATC)
Entity Type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:ALEXANDER
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-1410
Mailing Address - Country:US
Mailing Address - Phone:609-367-5022
Mailing Address - Fax:
Practice Address - Street 1:7 CHURCH ST
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-1410
Practice Address - Country:US
Practice Address - Phone:609-367-5022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer