Individual
MR. JACOB XAVIER MCCLELLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
11900 E 12 MILE RD STE 205, WARREN, MI 48093-3499
(586) 582-7033
(586) 200-6944
Mailing address
11800 E 12 MILE RD, WARREN, MI 48093-3472
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/24/2025
Last updated
03/24/2025
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