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General NPI Number Information
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NPI Number | 1184803587
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Entity Type | Individual
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Provider Name | SHADDON JAY CASE D.C.
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Gender | Male
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Dates
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Enumeration Date | 11/01/2007
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Last Update Date | 11/01/2007
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Provider Practice Location Address
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Address Line | 322 NORTH MAIN ST.
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City | SHARON SPRINGS
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State | KS
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Zip | 67758-0576
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Country | US
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Telephone | 785-852-4942
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Fax |
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Provider Business Mailing Address
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Address Line | 322 NORTH MAIN ST.
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City | SHARON SPRINGS
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State | KS
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Zip | 67758-0576
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Country | US
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Telephone | 785-852-4942
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 01-04554
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License Number State | KS
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