MEDICARE: DR. SHAWN EDWARD HARPER D.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	0104556115	VA

General Provider Information

NPI Number	:	1659555399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAWN EDWARD HARPER D.C.

Provider Business Mailing Address
First Line	:	320 S SYCAMORE ST
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23803-5041
Country	:	US
Telephone Number	:	571-265-9323
Fax Number	:

Provider Business Practice Location Address
First Line	:	320 S SYCAMORE ST
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23803-5041
Country	:	US
Telephone Number	:	571-265-9323
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/17/2007
Last Update Date	:	12/17/2007

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