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General NPI Number Information
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NPI Number | 1649418690
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Entity Type | Organization
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Legal Business Name | SHUMWAY WELLNESS CENTER INC
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Dates
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Enumeration Date | 01/29/2009
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Last Update Date | 10/03/2011
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Provider Practice Location Address
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Address Line | 3079 E. COMMERCIAL BLVD. SUITE 201
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City | FT. LAUDERDALE
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State | FL
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Zip | 33308-4311
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Country | US
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Telephone | 954-640-9893
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Fax | 954-200-7809
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Provider Business Mailing Address
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Address Line | 3079 E. COMMERCIAL BLVD. SUITE 201
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City | FT. LAUDERDALE
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State | FL
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Zip | 33308
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Country | US
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Telephone | 954-640-9893
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Fax | 954-200-7809
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AMY SHUMWAY
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Credential | D.C.
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Telephone | 954-640-9893
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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 | CH9337
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License Number State | FL
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