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Individual

DEREK MCCLURE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BOCPO

Contact information

Practice address
3433 BROADWAY ST, STE. # B3, AMERICAN CANYON, CA 94503-1229
(707) 643-2177
(707) 643-6339
Mailing address
3433 BROADWAY ST, STE. # B3, AMERICAN CANYON, CA 94503-1229
(707) 643-2177
(707) 643-6339

Taxonomy

Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
C46700
AZ

Other

Enumeration date
07/22/2014
Last updated
07/22/2014
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