MEDICARE: MARK A MCCANN DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2257	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841282514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK A MCCANN DC

Provider Business Mailing Address
First Line	:	105 CLARMAR DR
Second Line	:
City	:	SUN PRAIRIE
State	:	WI
Zip	:	53590-2675
Country	:	US
Telephone Number	:	608-318-5929
Fax Number	:	608-318-5922

Provider Business Practice Location Address
First Line	:	978 PARK ST
Second Line	:
City	:	OREGON
State	:	WI
Zip	:	53575-3653
Country	:	US
Telephone Number	:	608-835-8635
Fax Number	:	608-835-3772

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	06/27/2024

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Directions to “ MARK A MCCANN DC” Practice Location

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