Provider Demographics
NPI:1558750901
Name:MCCANSE, ANDREW (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:MCCANSE
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 1:300 CORNERSTONE DR
Mailing Address - Street 2:STE 215
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-4031
Mailing Address - Country:US
Mailing Address - Phone:802-557-0527
Mailing Address - Fax:802-488-3037
Practice Address - Street 1:300 CORNERSTONE DR
Practice Address - Street 2:STE 215
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-4012
Practice Address - Country:US
Practice Address - Phone:802-557-0527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-22
Last Update Date:2021-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT006.0093204111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor