Healthcare Provider Details

I. General information

NPI: 1093752644
Provider Name (Legal Business Name): JOSEPH JOHN SHENEMAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 07/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1322 S MAIN ST
EATON RAPIDS MI
48827-1921
US

IV. Provider business mailing address

1322 S MAIN ST
EATON RAPIDS MI
48827-1921
US

V. Phone/Fax

Practice location:
  • Phone: 517-663-7060
  • Fax: 517-663-7061
Mailing address:
  • Phone: 517-663-7060
  • Fax: 517-663-7061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301007294
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: