Individual
JENNA LYNN MCCLARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
75 INDUSTRIAL PARK RD STE D, FERDINAND, IN 47532-9667
(502) 882-9379
(502) 805-0526
Mailing address
PO BOX 5629, EVANSVILLE, IN 47716-5629
(502) 882-9379
(502) 805-0526
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05004123A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000092824
BLUE CROSS BLUE SHIELD
IN
05
—
200818580
—
IN
Enumeration date
12/02/2005
Last updated
07/12/2022
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