Provider Demographics
NPI:1780900282
Name:MCCLUNG, NANCY MANN (PT)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:MANN
Last Name:MCCLUNG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 DRUID HILLS AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-2325
Mailing Address - Country:US
Mailing Address - Phone:828-290-4240
Mailing Address - Fax:
Practice Address - Street 1:1629 DRUID HILLS AVE
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-2325
Practice Address - Country:US
Practice Address - Phone:828-290-4240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-09
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4355225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist