| Doctor Name: | MICHAEL MCCANCE |
| NPI Number: | 1154779924 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 500135 |
| Business Practice Address: | 120 W Stephen Foster Ave Suite 102 Bardstown, KY - 400041465 |
| Business Phone Number: | 5023480377 |
| Business Fax Number: | 5023480379 |
| Mailing Address: | 120 W Stephen Foster Ave, Suite 102 BARDSTOWN |
| State: | KY |
| Postal Code: | 400041465 |
| Phone Number: | 5023480377 |
| Fax Number: | 5023480379 |
| NPI Enumeration Date: | 06/02/2016 |
| NPI Last Update Date: | 06/02/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | 500135 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |