Individual
SHANE MICHAEL MCCLINTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
3200 GRAND AVE, DES MOINES, IA 50312-4104
(515) 271-1717
(515) 271-7185
Mailing address
3200 GRAND AVE, DES MOINES, IA 50312-4104
(515) 271-1717
(515) 271-7185
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
03284
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0282970
—
IA
01
—
650025696
RR MEDICARE
IA
Enumeration date
08/18/2005
Last updated
02/19/2020
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