Provider Demographics
NPI:1881952992
Name:MCCANN, JASON C (CO)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:C
Last Name:MCCANN
Suffix:
Gender:M
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3003 S KANSAS EXPY
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-5969
Mailing Address - Country:US
Mailing Address - Phone:417-883-5522
Mailing Address - Fax:417-883-2987
Practice Address - Street 1:3003 S KANSAS EXPY
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5969
Practice Address - Country:US
Practice Address - Phone:417-883-5522
Practice Address - Fax:417-883-2987
Is Sole Proprietor?:No
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist