MEDICARE: DR. PATRICK JAMES MCCANN D.C.

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	4366-012	WI

General Provider Information

NPI Number	:	1730363045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK JAMES MCCANN D.C.

Provider Business Mailing Address
First Line	:	17585 W NORTH AVE
Second Line	:	SUITE 130
City	:	BROOKFIELD
State	:	WI
Zip	:	53045-4365
Country	:	US
Telephone Number	:	262-782-9700
Fax Number	:	262-782-9702

Provider Business Practice Location Address
First Line	:	17585 W NORTH AVE
Second Line	:	SUITE 130
City	:	BROOKFIELD
State	:	WI
Zip	:	53045-4365
Country	:	US
Telephone Number	:	262-782-9700
Fax Number	:	262-782-9702

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

Provider Enumeration Date	:	12/21/2007
Last Update Date	:	10/07/2011

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