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General NPI Number Information
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NPI Number | 1154487312
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Entity Type | Organization
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Legal Business Name | MCCANN FAMILY CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 02/28/2013
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Provider Practice Location Address
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Address Line | 11605 STATE AVE STE 111
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City | MARYSVILLE
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State | WA
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Zip | 98271-8427
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Country | US
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Telephone | 360-657-7183
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Fax | 360-657-7188
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Provider Business Mailing Address
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Address Line | 11605 STATE AVE STE 111
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City | MARYSVILLE
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State | WA
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Zip | 98271-8427
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Country | US
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Telephone | 360-657-7183
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Fax | 360-657-7188
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Authorized Official
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Title or Position | OWNER
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Name | DR. MATTHEW MCCANN
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Credential | D.C.
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Telephone | 360-657-7183
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH00034346
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License Number State | WA
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