| Doctor Name: | NICOLE ALYSON MCCLONE |
| NPI Number: | 1003160896 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | PT27401 |
| Business Practice Address: | 236 Ponte Vedra Park Dr Ponte Vedra Beach, FL - 320826619 |
| Business Phone Number: | 9042803440 |
| Business Fax Number: | |
| Mailing Address: | 101 16th Ave S, Unit C JACKSONVILLE BEACH |
| State: | FL |
| Postal Code: | 322506398 |
| Phone Number: | 9413210747 |
| Fax Number: | |
| NPI Enumeration Date: | 11/01/2012 |
| NPI Last Update Date: | 05/10/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | PT27401 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |