Provider Demographics
NPI:1750124467
Name:MCKEAN, JEFFREY T (DAC, MAC-CHM, LAC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:T
Last Name:MCKEAN
Suffix:
Gender:M
Credentials:DAC, MAC-CHM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 FENWAY APT 12
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-3714
Mailing Address - Country:US
Mailing Address - Phone:617-835-7977
Mailing Address - Fax:
Practice Address - Street 1:114 FENWAY APT 12
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-3714
Practice Address - Country:US
Practice Address - Phone:617-835-7977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist