McKenzie Alexandra McClanahan, DPT
Individual provider Active NPI Pediatric Physical Therapist · Horn Lake, MS
NPI 1417560913 · NPPES record last updated Aug 25, 2020
Key facts
- NPI
- 1417560913
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Physical Therapist 2251P0200X
- License
- 12898 (TN)
- Practice address
- 1751 Dancy Blvd Ste 2
Horn Lake, MS 38637-1916 - Phone
- (901) 292-5313
- Fax
- (901) 867-1603
- NPI assigned
- Aug 25, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12898 | TN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Therapy Service | Multi-Specialty | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist |
2251P0200X | 12898 | TN | Yes |
Addresses
Primary practice location
1751 Dancy Blvd Ste 2
Horn Lake, MS 38637-1916
Mailing address
29 Normandy Cir
Memphis, TN 38111-6135
Phone (901) 491-2540
Other providers in Horn Lake, MS
- Jessica Lucovich
- Adam C Marshall
- John Barrett Martindale
- Justin Mathis
- William P McAlexander
- Memphis Emergency Specialists PC
- Mid South Chiropractic of Horn Lake PLLC
- Ragan Danielle Middleton
- William E. Middleton Jr.
- Midsouth Medical Specialties LLC
All providers in Horn Lake, MS · Pediatric Physical Therapist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.