Provider Demographics
NPI:1891280095
Name:MCCLACHERTY, STATEN (DC)
Entity Type:Individual
Prefix:DR
First Name:STATEN
Middle Name:
Last Name:MCCLACHERTY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:67661-1612
Mailing Address - Country:US
Mailing Address - Phone:785-543-2700
Mailing Address - Fax:
Practice Address - Street 1:875 3RD ST
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:KS
Practice Address - Zip Code:67661-1612
Practice Address - Country:US
Practice Address - Phone:785-543-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-29
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05871111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor