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General NPI Number Information
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NPI Number | 1467942789
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Entity Type | Organization
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Legal Business Name | WADE A. SHAFFER D.C. INC.
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Dates
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Enumeration Date | 05/11/2018
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Last Update Date | 07/11/2018
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Provider Practice Location Address
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Address Line | 3682 W LAKE RD
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City | ERIE
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State | PA
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Zip | 16505
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Country | US
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Telephone | 814-836-8989
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Fax |
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Provider Business Mailing Address
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Address Line | 3682 W LAKE RD
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City | ERIE
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State | PA
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Zip | 16505-3455
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Country | US
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Telephone | 814-836-8989
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Fax |
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Authorized Official
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Title or Position | DR. OF CHIROPRACTIC
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Name | DR. WADE A SHAFFER
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Credential | D.C.
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Telephone | 814-836-8989
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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 | DC007311L
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License Number State | PA
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