MEDICARE: SHIN FAMILY CHIROPRACTIC & REHABILITATION, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC010156	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013260462
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHIN FAMILY CHIROPRACTIC & REHABILITATION, P.C.

Provider Business Mailing Address
First Line	:	1200 WELSH RD # F2
Second Line	:
City	:	NORTH WALES
State	:	PA
Zip	:	19454-3771
Country	:	US
Telephone Number	:	215-647-2188
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 WELSH RD # F2
Second Line	:
City	:	NORTH WALES
State	:	PA
Zip	:	19454-3771
Country	:	US
Telephone Number	:	215-647-2188
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SEUNGMOOK SHIN
Credential	:	D.C.
Telephone Number	:	215-647-2188

Provider Enumeration Date	:	10/23/2012
Last Update Date	:	04/30/2019

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