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TINA MARIA MCCLURE

>> Chore Provider >> Nursing Service Related Providers

Registrant NPI Number: 1720273394

Individual Registrant:
 TINA MARIA MCCLURE 
Gender: F
Sole Proprietor

Location and contact information for practice:
206 E 5TH ST  LAKE PARK, IA 51347-7745 US
Tel: 712-832-3888  Fax: --

Contact information for business:
206 E 5TH ST P.O. BOX 504 LAKE PARK, IA 51347-7745 US
Tel: 712-832-3888  Fax: --

Registration Information:
NPI: 1720273394
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y372500000XNursing Service Related Providers
Chore Provider
IA

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
MEDICAID PROVIDER NUMBER0191551IA01




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