Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 6154 | MN |
N | 111NP0017X | Pediatric Chiropractor | 6154 | MN |
NPI | 1386007607 |
---|---|
Provider Name | Dr. Ian Patrick Mccann |
First Address | Chanhassen, MN 55317-4502 |
Second Address | Chanhassen, MN 55317-4502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2016 |
Last Update Date | 02/11/2018 |