Provider Demographics
NPI:1649295338
Name:MCLEAN, SANDRA L (DC)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:L
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8041 SE EAGLEWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:HOBE SOUND
Mailing Address - State:FL
Mailing Address - Zip Code:33455-7646
Mailing Address - Country:US
Mailing Address - Phone:561-412-9324
Mailing Address - Fax:
Practice Address - Street 1:809 S LONG DR STE A
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-4375
Practice Address - Country:US
Practice Address - Phone:910-997-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007730111N00000X
FL10647111N00000X
NC5569111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
M74030002Medicare ID - Type Unspecified
U73312Medicare UPIN