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General NPI Number Information
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NPI Number | 1427239359
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Entity Type | Organization
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Legal Business Name | SHANK CHIROPRACTIC CLINIC LLC
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Dates
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Enumeration Date | 11/20/2007
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Last Update Date | 12/13/2007
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Provider Practice Location Address
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Address Line | 713 TAYWOOD RD
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City | ENGLEWOOD
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State | OH
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Zip | 45322
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Country | US
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Telephone | 937-558-1256
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Fax | 937-558-1273
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Provider Business Mailing Address
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Address Line | 713 TAYWOOD RD
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City | ENGLEWOOD
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State | OH
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Zip | 45322
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Country | US
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Telephone | 937-558-1256
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Fax | 937-558-1273
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. JENNIFER L SHANK
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Credential |
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Telephone | 937-558-1256
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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 |
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License Number State |
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