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General NPI Number Information
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NPI Number | 1538535026
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Entity Type | Organization
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Legal Business Name | MAY FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 08/19/2015
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Last Update Date | 08/19/2015
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Provider Practice Location Address
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Address Line | 8 EAGLE CTR SUITE 16
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City | O FALLON
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State | IL
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Zip | 62269-1947
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Country | US
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Telephone | 618-628-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 8 EAGLE CTR SUITE 16
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City | O FALLON
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State | IL
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Zip | 62269-1947
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Country | US
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Telephone | 618-628-1111
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. SHANE L MAY
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Credential | D.C.
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Telephone | 618-628-1111
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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 | 038.009623
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License Number State | IL
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