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General NPI Number Information
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NPI Number | 1780055517
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Entity Type | Organization
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Legal Business Name | SHAWN P KENDRICK DC PLLC
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Dates
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Enumeration Date | 10/20/2015
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Last Update Date | 10/20/2015
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Provider Practice Location Address
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Address Line | 1414 W 3RD ST
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City | FARMVILLE
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State | VA
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Zip | 23901-2648
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Country | US
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Telephone | 434-392-9807
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Fax | 434-392-7081
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Provider Business Mailing Address
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Address Line | 1414 W 3RD ST
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City | FARMVILLE
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State | VA
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Zip | 23901-2648
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Country | US
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Telephone | 434-392-9807
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Fax | 434-392-7081
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Authorized Official
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Title or Position | MANAGER
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Name | DR. SHAWN P KENDRICK
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Credential | D.C.
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Telephone | 434-392-9807
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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 | 0104557015
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License Number State | VA
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