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NPI Code Detail

MEDICARE: BEAU SHANNON LAWYER D.C.

MEDICARE: BEAU SHANNON LAWYER D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor1915OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336182138
Entity Type Code : Individual
Provider Name (Legal Business Name) : BEAU SHANNON LAWYER D.C.
Provider Business Mailing Address
First Line : 910 NEIL AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43215-1333
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1400 W 5TH AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43212-2901
Country : US
Telephone Number : 614-486-6755
Fax Number : 614-486-6781
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2006
Last Update Date : 09/10/2010

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Directions to “ BEAU SHANNON LAWYER D.C.” Practice Location

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