Provider Demographics
NPI:1801966056
Name:MCLAIN, BENJAMIN W (MBA, ATC)
Entity type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:W
Last Name:MCLAIN
Suffix:
Gender:M
Credentials:MBA, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6926 SE 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34480-6228
Mailing Address - Country:US
Mailing Address - Phone:352-390-3726
Mailing Address - Fax:
Practice Address - Street 1:1015 SE 17TH ST STE 300
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-3943
Practice Address - Country:US
Practice Address - Phone:352-690-7777
Practice Address - Fax:352-690-7788
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL16862255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer