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NPI Code Detail

MEDICARE: CORRINA SHAMPO DC

MEDICARE: CORRINA SHAMPO DC
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
1111N00000XChiropractor2301011009MI

General Provider Information

NPI Number : 1952902504
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORRINA SHAMPO DC
Provider Business Mailing Address
First Line : 1205 PYLE DR
Second Line :
City : KINGSFORD
State : MI
Zip : 49802-1132
Country : US
Telephone Number : 906-828-1349
Fax Number :
Provider Business Practice Location Address
First Line : 1205 PYLE DR
Second Line :
City : KINGSFORD
State : MI
Zip : 49802-1132
Country : US
Telephone Number : 906-828-1349
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2020
Last Update Date : 06/07/2024

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Directions to “ CORRINA SHAMPO DC” Practice Location

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