Healthcare Provider Details

I. General information

NPI: 1013076884
Provider Name (Legal Business Name): WILLIAM KING SHAFFER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5014 CARLISLE PIKE
MECHANICSBURG PA
17050-2401
US

IV. Provider business mailing address

5014 CARLISLE PIKE
MECHANICSBURG PA
17050-2401
US

V. Phone/Fax

Practice location:
  • Phone: 717-737-6770
  • Fax: 717-737-1566
Mailing address:
  • Phone: 717-737-6770
  • Fax: 717-737-1566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberDC001204L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: