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General NPI Number Information
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NPI Number | 1407371495
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Entity Type | Organization
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Legal Business Name | ANDREW SHEPHERD INC.
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Dates
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Enumeration Date | 08/10/2017
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Last Update Date | 08/10/2017
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Provider Practice Location Address
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Address Line | 3 S 12TH ST FL 3
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City | RICHMOND
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State | VA
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Zip | 23219-4096
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Country | US
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Telephone | 804-276-4760
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 S MEADOW ST
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City | RICHMOND
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State | VA
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Zip | 23220-6614
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Country | US
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Telephone | 757-810-8360
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. ANDREW CLARK SHEPHERD
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Credential | DC
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Telephone | 757-810-8360
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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 | 0104557364
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License Number State | VA
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