MEDICARE: DR. SHANE PATRICK MORRISON 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	111NR0400X	Rehabilitation Chiropractor	0104556726	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	270737178	OTHER	VA	AETNA
2	270737178	OTHER	VA	OPTIMA
3	270737178	OTHER	VA	CIGNA
4	270737178	OTHER	VA	ANTHEM BLUE CROSS AND BLUE SHIELD VIRGINIA
5	270737178	OTHER	VA	ASHN

General Provider Information

NPI Number	:	1942431952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHANE PATRICK MORRISON D.C.

Provider Business Mailing Address
First Line	:	6070 INDIAN RIVER RD.
Second Line	:	STE. 102
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464
Country	:	US
Telephone Number	:	757-313-2304
Fax Number	:

Provider Business Practice Location Address
First Line	:	6070 INDIAN RIVER RD
Second Line	:	SUITE 102
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-3895
Country	:	US
Telephone Number	:	757-313-2304
Fax Number	:

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

Provider Enumeration Date	:	08/07/2009
Last Update Date	:	01/11/2010

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Directions to “ DR. SHANE PATRICK MORRISON D.C.” Practice Location

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