Individual
MIRANDA ELYSE MCCLURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
123 FAIR HAVENS DR, HIRAM, GA 30141-4718
(678) 499-3042
Mailing address
123 FAIR HAVENS DR, HIRAM, GA 30141-4718
(678) 499-3042
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
12/09/2019
Last updated
12/09/2019
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