Provider Demographics
NPI:1891007779
Name:MCCLOUD, AARON B (LMT)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:B
Last Name:MCCLOUD
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1373
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17608-1373
Mailing Address - Country:US
Mailing Address - Phone:717-299-2410
Mailing Address - Fax:
Practice Address - Street 1:604 NEW HOLLAND AVE
Practice Address - Street 2:STE G
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2199
Practice Address - Country:US
Practice Address - Phone:717-299-2410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG002048225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist