MEDICARE: DR. KEVIN MATTHEW SHIRLEY 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	DC010116	PA

General Provider Information

NPI Number	:	1811183726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN MATTHEW SHIRLEY D.C.

Provider Business Mailing Address
First Line	:	PO BOX 435
Second Line	:
City	:	CARMICHAELS
State	:	PA
Zip	:	15320-0435
Country	:	US
Telephone Number	:	563-340-1022
Fax Number	:	724-966-2074

Provider Business Practice Location Address
First Line	:	1030 BOYCE RD
Second Line	:
City	:	UPPER ST CLAIR
State	:	PA
Zip	:	15241-3907
Country	:	US
Telephone Number	:	412-257-8090
Fax Number	:	412-257-8121

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

Provider Enumeration Date	:	09/25/2007
Last Update Date	:	10/14/2010

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