Provider Demographics
NPI:1639700909
Name:MCCANN, KYLAR SUE (DC)
Entity type:Individual
Prefix:
First Name:KYLAR
Middle Name:SUE
Last Name:MCCANN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2749 86TH ST
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-4336
Mailing Address - Country:US
Mailing Address - Phone:641-223-3418
Mailing Address - Fax:
Practice Address - Street 1:2749 86TH ST
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-4336
Practice Address - Country:US
Practice Address - Phone:641-223-3418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-27
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA108224111N00000X
MO2020002798111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor