MEDICARE: DR. SHANE M. LINDAUER 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
1	111N00000X	Chiropractor	08002185A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000358521	OTHER	IN	BLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number	:	1336224666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHANE M. LINDAUER D.C.

Provider Business Mailing Address
First Line	:	695 W 2ND ST
Second Line	:
City	:	JASPER
State	:	IN
Zip	:	47546-3240
Country	:	US
Telephone Number	:	812-482-4111
Fax Number	:	812-482-4133

Provider Business Practice Location Address
First Line	:	695 W 2ND ST
Second Line	:
City	:	JASPER
State	:	IN
Zip	:	47546-3240
Country	:	US
Telephone Number	:	812-482-4111
Fax Number	:	812-482-4133

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	07/08/2007

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