Healthcare Provider Details

I. General information

NPI: 1023949138
Provider Name (Legal Business Name): SHORES CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2424 LISENBY AVE
PANAMA CITY FL
32405-3585
US

IV. Provider business mailing address

2424 LISENBY AVE
PANAMA CITY FL
32405-3585
US

V. Phone/Fax

Practice location:
  • Phone: 850-819-8083
  • Fax: 850-848-6666
Mailing address:
  • Phone: 850-819-8083
  • Fax: 850-848-6666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. JONATHAN SHORES
Title or Position: OWNER
Credential: DC
Phone: 850-819-8083