Healthcare Provider Details

I. General information

NPI: 1821909904
Provider Name (Legal Business Name): MEGAN MCCANSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 MAIN ST
SAINT JOSEPH MI
49085-1595
US

IV. Provider business mailing address

205 MAIN ST UNIT 194
SAINT JOSEPH MI
49085-5507
US

V. Phone/Fax

Practice location:
  • Phone: 269-281-8991
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: