Individual
JOSEPH MACLELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5700 COOPER FOSTER PARK RD W, LORAIN, OH 44053-4152
(440) 204-7400
Mailing address
622 YARMOUTH DR, BAY VILLAGE, OH 44140-1755
(440) 334-7777
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.003170RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000
—
OH
Enumeration date
08/28/2010
Last updated
06/18/2024
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