Individual
TIMITHY MARK MCCLELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
25 S 9TH ST, PHILADELPHIA, PA 19107-4408
(215) 955-1200
Mailing address
25 S 9TH ST, PHILADELPHIA, PA 19107-4408
(215) 955-1200
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
OS024117
PA
390200000X
Student in an Organized Health Care Education/Training Program
OT022008
PA
Other
Enumeration date
03/22/2021
Last updated
04/18/2025
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