Provider Demographics
NPI:1093875049
Name:SHAFER CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:SHAFER CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:E
Authorized Official - Last Name:SHAFER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-837-4559
Mailing Address - Street 1:1156 WINDCREST DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-6247
Mailing Address - Country:US
Mailing Address - Phone:724-837-4559
Mailing Address - Fax:724-837-4356
Practice Address - Street 1:2030 FREDRICKSON PL
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-9688
Practice Address - Country:US
Practice Address - Phone:724-837-4559
Practice Address - Fax:724-837-4356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006283L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016853370003Medicaid
PA0016853370003Medicaid
PAU56795Medicare UPIN