Mccormack, Regan Roy
Mccormack, Regan Roy is an individual health care provider with primary practice located at 519 Shepherds Drive , West Bend WI 53090. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Mccormack, Regan Roy can be contacted via phone (262) 306-9775.Contact Information
Primary practice address
519 Shepherds Drive
West Bend WI 53090
Phone: (262) 306-9775
Fax: (262) 306-9183
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 3559012 | Wisconsin |
Profile Details
| NPI number | 1346324340 |
|---|---|
| LBN Legal business name | Mccormack, Regan Roy |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 25th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346324340 | NPPES |
| Wisconsin | MEDICAID | 38961400 |
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