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General NPI Number Information
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NPI Number | 1427388446
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Entity Type | Organization
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Legal Business Name | DAVIS CHIROPRACTIC CENTER, P.C.
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Dates
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Enumeration Date | 01/14/2010
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Last Update Date | 01/14/2010
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Provider Practice Location Address
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Address Line | 842 N EDWARDSVILLE ST
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City | STAUNTON
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State | IL
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Zip | 62088-1156
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Country | US
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Telephone | 618-635-3046
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Fax |
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Provider Business Mailing Address
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Address Line | 842 N EDWARDSVILLE ST
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City | STAUNTON
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State | IL
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Zip | 62088-1156
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Country | US
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Telephone | 618-635-3046
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER/CHIROPRACTOR
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Name | DR. SHAWN CHRISTOPHER DAVIS
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Credential | D.C.
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Telephone | 618-635-0346
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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 | 038.008353
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License Number State | IL
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