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Individual
COLTON J MCCLURE
Active
Individual
COLTON J MCCLURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP022959
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP022959
STATE LICENSE
PA
Enumeration date
12/11/2020
Last updated
11/30/2021
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