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General NPI Number Information
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NPI Number | 1972659415
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Entity Type | Organization
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Legal Business Name | SHAW CHIROPRACTIC CENTER
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 10/16/2007
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Provider Practice Location Address
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Address Line | 305 N ANDERSON
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City | ELLENSBURG
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State | WA
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Zip | 98926-3361
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Country | US
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Telephone | 509-962-9633
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Fax | 509-962-9634
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Provider Business Mailing Address
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Address Line | 305 N ANDERSON
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City | ELLENSBURG
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State | WA
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Zip | 98926-3361
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Country | US
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Telephone | 509-962-9633
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Fax | 509-962-9634
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. F JAMES SHAW JR.
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Credential | DC
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Telephone | 509-962-9633
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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 | CH00001232
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License Number State | WA
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