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General NPI Number Information
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NPI Number | 1437300985
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Entity Type | Organization
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Legal Business Name | BRIAN C. SHANE, INC.
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Dates
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Enumeration Date | 10/02/2008
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Last Update Date | 10/02/2008
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Provider Practice Location Address
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Address Line | 922 SE FRANK PHILLIPS BLVD
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City | BARTLESVILLE
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State | OK
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Zip | 74003-4230
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Country | US
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Telephone | 918-336-8316
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Fax | 918-336-8780
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Provider Business Mailing Address
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Address Line | 922 SE FRANK PHILLIPS BLVD
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City | BARTLESVILLE
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State | OK
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Zip | 74003-4230
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Country | US
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Telephone | 918-336-8316
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Fax | 918-336-8780
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRIAN CHARLES SHANE
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Credential | DC
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Telephone | 918-336-8316
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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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