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General NPI Number Information
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NPI Number | 1013260462
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Entity Type | Organization
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Legal Business Name | SHIN FAMILY CHIROPRACTIC & REHABILITATION, P.C.
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Dates
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Enumeration Date | 10/23/2012
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Last Update Date | 04/30/2019
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Provider Practice Location Address
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Address Line | 1200 WELSH RD # F2
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City | NORTH WALES
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State | PA
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Zip | 19454-3771
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Country | US
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Telephone | 215-647-2188
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 WELSH RD # F2
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City | NORTH WALES
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State | PA
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Zip | 19454-3771
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Country | US
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Telephone | 215-647-2188
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SEUNGMOOK SHIN
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Credential | D.C.
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Telephone | 215-647-2188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC010156
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License Number State | PA
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