Provider Demographics
NPI:1477643393
Name:MCLAGAN, SHAD ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:SHAD
Middle Name:ALAN
Last Name:MCLAGAN
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 1:62940 O B RILEY RD STE 2
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-9441
Mailing Address - Country:US
Mailing Address - Phone:541-318-8627
Mailing Address - Fax:541-318-8697
Practice Address - Street 1:62940 O B RILEY RD STE 2
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-9441
Practice Address - Country:US
Practice Address - Phone:541-318-8627
Practice Address - Fax:541-318-8697
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR713634111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor