Provider Demographics
NPI:1396588414
Name:MCLARENCARE PHYSICAL THERAPY - LAWRENCEVILLE LLC
Entity type:Organization
Organization Name:MCLARENCARE PHYSICAL THERAPY - LAWRENCEVILLE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:MCLAREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-384-4756
Mailing Address - Street 1:3755 BRIDLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-1068
Mailing Address - Country:US
Mailing Address - Phone:404-384-4756
Mailing Address - Fax:
Practice Address - Street 1:3370 SUGARLOAF PKWY STE B4 & B5
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-5478
Practice Address - Country:US
Practice Address - Phone:470-706-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty