Healthcare Provider Details

I. General information

NPI: 1669918207
Provider Name (Legal Business Name): SHELBY FRANCE DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2017
Last Update Date: 01/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

784 FRANKLIN AVE STE 230
FRANKLIN LAKES NJ
07417-1306
US

IV. Provider business mailing address

784 FRANKLIN AVE STE 230
FRANKLIN LAKES NJ
07417-1306
US

V. Phone/Fax

Practice location:
  • Phone: 201-891-4100
  • Fax: 201-891-0014
Mailing address:
  • Phone: 201-891-4100
  • Fax: 201-891-0014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00737600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: