Provider Demographics
NPI:1043482136
Name:SHROPSHIRE, KRISTAL DAWN (DC)
Entity Type:Individual
Prefix:
First Name:KRISTAL
Middle Name:DAWN
Last Name:SHROPSHIRE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 F ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3843
Mailing Address - Country:US
Mailing Address - Phone:661-864-7999
Mailing Address - Fax:661-864-7997
Practice Address - Street 1:2530 F ST
Practice Address - Street 2:SUITE 102
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3843
Practice Address - Country:US
Practice Address - Phone:661-864-7999
Practice Address - Fax:661-864-7997
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-28
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30895111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0308950Medicare PIN