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General NPI Number Information
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NPI Number | 1154615623
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Entity Type | Organization
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Legal Business Name | DR. JOHN SHANLEY CHIROPRACTIC PHYSICIAN LLC
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Dates
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Enumeration Date | 06/02/2011
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Last Update Date | 06/02/2011
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Provider Practice Location Address
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Address Line | 450 MAIN ST SUITE B
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City | WINTERSVILLE
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State | OH
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Zip | 43953-3770
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Country | US
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Telephone | 740-512-9763
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Fax | 888-624-8339
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Provider Business Mailing Address
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Address Line | 115 MARION PL
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City | STEUBENVILLE
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State | OH
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Zip | 43953-3456
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Country | US
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Telephone | 740-512-6206
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Fax | 888-624-8339
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. JOHN SHANLEY JR.
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Credential | D.C.
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Telephone | 740-512-9763
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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 | 3670
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License Number State | OH
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