Provider Demographics
NPI:1578151999
Name:INI PC
Entity Type:Organization
Organization Name:INI PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCANSE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:802-793-6347
Mailing Address - Street 1:300 CORNERSTONE DR STE 215
Mailing Address - Street 2:
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 STE 215
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-4031
Practice Address - Country:US
Practice Address - Phone:802-557-0527
Practice Address - Fax:802-488-3037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-03
Last Update Date:2021-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty