Healthcare Provider Details
I. General information
NPI: 1942253232
Provider Name (Legal Business Name): ANTRIM CHIROPRACTIC CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11416 WILLIAMSPORT PIKE
GREENCASTLE PA
17225-8465
US
IV. Provider business mailing address
11416 WILLIAMSPORT PIKE
GREENCASTLE PA
17225-8465
US
V. Phone/Fax
- Phone: 717-597-0028
- Fax: 717-597-0033
- Phone: 717-597-0028
- Fax: 717-597-0033
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | DC009020 |
| License Number State | PA |
VIII. Authorized Official
Name: DR.
SHAWN
M
NEFF
Title or Position: MEMBER
Credential: D.C.
Phone: 717-597-0028