Provider Demographics
NPI:1922156389
Name:MCCLUNG, ANN W (PT)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:W
Last Name:MCCLUNG
Suffix:
Gender:F
Credentials:PT
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Mailing Address - Street 1:420 W PINHOOK RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2131
Mailing Address - Country:US
Mailing Address - Phone:337-233-1307
Mailing Address - Fax:337-233-5764
Practice Address - Street 1:RR 2 BOX 169-G
Practice Address - Street 2:GRAYROCK PROFESSIONAL PARK
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-9316
Practice Address - Country:US
Practice Address - Phone:304-645-1706
Practice Address - Fax:304-645-4085
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WV000155225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist