Provider Demographics
NPI:1730363045
Name:MCCANN, PATRICK JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:JAMES
Last Name:MCCANN
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 1:17585 W NORTH AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-4365
Mailing Address - Country:US
Mailing Address - Phone:262-782-9700
Mailing Address - Fax:262-782-9702
Practice Address - Street 1:17585 W NORTH AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-4365
Practice Address - Country:US
Practice Address - Phone:262-782-9700
Practice Address - Fax:262-782-9702
Is Sole Proprietor?:No
Enumeration Date:2007-12-21
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4366-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor