Organization
CAPITOL REHAB OF CROFTON INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAUN R MCCLENNY D.C. (OWNER/DR.)
(410) 451-3561
Entity
Organization
Contact information
Practice address
1625 CROFTON CTR, CROFTON, MD 21114-1318
(410) 451-3561
(410) 451-2265
Mailing address
1625 CROFTON CTR, CROFTON, MD 21114-1318
(410) 451-3561
(410) 451-2265
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
03452
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104941509
NPI TYPE 1
MD
01
—
64671401
CAREFIRST
MD
01
—
K7710001
BLUECROSS BLUESHIELD
MD
Enumeration date
04/21/2010
Last updated
12/01/2010
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