| Doctor Name: | MARIELLEN MCCLORY |
| NPI Number: | 1386853885 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 30020 |
| Business Practice Address: | 2045 Franklin St Denver, CO - 802055437 |
| Business Phone Number: | 3037644899 |
| Business Fax Number: | |
| Mailing Address: | 10932 W Exposition Dr, LAKEWOOD |
| State: | CO |
| Postal Code: | 802263820 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/21/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 30020 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |