Individual
REGAN ROY MCCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
519 SHEPHERDS DRIVE, WEST BEND, WI 53090
(262) 306-9775
(262) 306-9183
Mailing address
519 SHEPHERDS DRIVE, WEST BEND, WI 53090
(262) 306-9775
(262) 306-9183
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3559012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38961400
—
WI
Enumeration date
10/25/2006
Last updated
07/08/2007
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