Provider Demographics
NPI:1386007607
Name:MCCANN, IAN PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:PATRICK
Last Name:MCCANN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 W 78TH ST
Mailing Address - Street 2:
Mailing Address - City:CHANHASSEN
Mailing Address - State:MN
Mailing Address - Zip Code:55317-4502
Mailing Address - Country:US
Mailing Address - Phone:952-474-1544
Mailing Address - Fax:952-474-1545
Practice Address - Street 1:2675 W 78TH ST
Practice Address - Street 2:
Practice Address - City:CHANHASSEN
Practice Address - State:MN
Practice Address - Zip Code:55317-4502
Practice Address - Country:US
Practice Address - Phone:651-731-0505
Practice Address - Fax:952-414-1545
Is Sole Proprietor?:No
Enumeration Date:2016-04-04
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6154111NP0017X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor