Individual
BENJAMIN MCCLURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3115 SUNSET BLVD, WEST COLUMBIA, SC 29169-3425
(803) 791-3722
Mailing address
181 W PROFESSIONAL PARK CT STE 1, BOWLING GREEN, KY 42104-3250
(270) 777-9283
(270) 777-9283
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
18-47076
SC
Other
Enumeration date
01/22/2018
Last updated
01/22/2018
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