Provider Demographics
NPI:1467641936
Name:MCNEIL, IAN A (DC)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:A
Last Name:MCNEIL
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 1:12300 SINGLETREE LN STE 200
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-7964
Mailing Address - Country:US
Mailing Address - Phone:952-941-2225
Mailing Address - Fax:952-903-2816
Practice Address - Street 1:12300 SINGLETREE LN STE 200
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-7964
Practice Address - Country:US
Practice Address - Phone:952-941-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-19
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4213111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN3500003559Medicare NSC