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NPI Code Detail

MEDICARE: DR. SHANE BECKER DC

MEDICARE: DR. SHANE BECKER DC
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
1111N00000XChiropractor38MC00750600NJ

General Provider Information

NPI Number : 1477055226
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHANE BECKER DC
Provider Business Mailing Address
First Line : 300 S LENOLA RD
Second Line : # 23
City : MAPLE SHADE
State : NJ
Zip : 08052-3435
Country : US
Telephone Number : 856-733-0684
Fax Number :
Provider Business Practice Location Address
First Line : 300 S LENOLA RD
Second Line : # 23
City : MAPLE SHADE
State : NJ
Zip : 08052-3435
Country : US
Telephone Number : 856-733-0684
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2018
Last Update Date : 05/14/2018

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Directions to “ DR. SHANE BECKER DC” Practice Location

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