MEDICARE: SHUSMAN CHIROPRACTIC

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	DC002968L	PA

General Provider Information

NPI Number	:	1932228970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHUSMAN CHIROPRACTIC

Provider Business Mailing Address
First Line	:	6812 CASTOR AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19149-2106
Country	:	US
Telephone Number	:	215-725-2225
Fax Number	:	215-725-2242

Provider Business Practice Location Address
First Line	:	6812 CASTOR AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19149-2106
Country	:	US
Telephone Number	:	215-725-2225
Fax Number	:	215-725-2242

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	JEFFREY SHUSMAN
Credential	:	DC
Telephone Number	:	215-725-2225

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	08/22/2020

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