1073871539 NPI number — SHROPSHIRE CHIROPRACTIC, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073871539 NPI number — SHROPSHIRE CHIROPRACTIC, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SHROPSHIRE CHIROPRACTIC, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073871539
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/02/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2530 F ST
Provider Second Line Business Mailing Address:
SUITE 102
Provider Business Mailing Address City Name:
BAKERSFIELD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93301-3843
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-864-7999
Provider Business Mailing Address Fax Number:
661-864-7977

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2530 F ST
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93301-3843
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-864-7999
Provider Business Practice Location Address Fax Number:
661-864-7977
Provider Enumeration Date:
05/02/2012

Additional Information

Authorized Official

Authorized Official Last Name:
SHROPSHIRE
Authorized Official First Name:
KRISTAL
Authorized Official Middle Name:
DAWN
Authorized Official Title or Position:
OWNER/DOCTOR
Authorized Official Telephone Number:
661-864-7999

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  30895 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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