Provider Demographics
NPI:1295998276
Name:MCCLURE, RACHAEL L
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:L
Last Name:MCCLURE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1953 SCOTTSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-3388
Mailing Address - Country:US
Mailing Address - Phone:270-745-1006
Mailing Address - Fax:270-796-5544
Practice Address - Street 1:1953 SCOTTSVILLE RD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-3388
Practice Address - Country:US
Practice Address - Phone:270-745-1006
Practice Address - Fax:270-796-5544
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY002444225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist