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General NPI Number Information
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NPI Number | 1497781280
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Entity Type | Individual
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Provider Name | SHAWNA HOGAN D.C.
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Gender | Female
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 07/13/2012
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Provider Practice Location Address
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Address Line | 4481 LEGENDARY DR
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City | DESTIN
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State | FL
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Zip | 32541-5381
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Country | US
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Telephone | 850-424-7856
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Fax |
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Provider Business Mailing Address
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Address Line | 5953 COMMERCE RD
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City | MILTON
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State | FL
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Zip | 32583-2320
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Country | US
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Telephone | 850-748-6102
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | CH8365
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License Number State | FL
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