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General NPI Number Information
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NPI Number | 1932440476
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Entity Type | Individual
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Provider Name | JONATHAN RYAN SHANER D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/07/2013
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Last Update Date | 03/07/2013
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Provider Practice Location Address
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Address Line | 6500 N MOPAC EXPY BLDG. 3, SUITE 101
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City | AUSTIN
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State | TX
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Zip | 78731-3282
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Country | US
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Telephone | 512-491-7772
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Fax | 512-339-6806
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Provider Business Mailing Address
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Address Line | 6500 N MOPAC EXPY BLDG. 3, SUITE 101
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City | AUSTIN
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State | TX
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Zip | 78731-3282
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Country | US
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Telephone | 512-491-7772
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Fax | 512-339-6806
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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 | 12267
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License Number State | TX
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