Provider Demographics
NPI:1255702585
Name:MCLAIN, JUSTIN (DC)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:
Last Name:MCLAIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 S MENDENHALL RD STE 283
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-2827
Mailing Address - Country:US
Mailing Address - Phone:901-428-7756
Mailing Address - Fax:901-767-6223
Practice Address - Street 1:3558 KIRBY PKWY
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-4243
Practice Address - Country:US
Practice Address - Phone:901-566-1203
Practice Address - Fax:901-566-1206
Is Sole Proprietor?:No
Enumeration Date:2015-10-13
Last Update Date:2016-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2896111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor