Individual
MR. CHASE JENTRY MCCLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
300 S 8TH ST STE 480W, MURRAY, KY 42071-2403
(270) 753-0704
Mailing address
PO BOX 14143, BELFAST, ME 04915-4032
(270) 762-1321
(270) 767-3613
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA2813
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2020
Last updated
12/09/2021
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