Provider Demographics
NPI:1144233883
Name:SHOTWELL, MURIEL E (D C)
Entity Type:Individual
Prefix:DR
First Name:MURIEL
Middle Name:E
Last Name:SHOTWELL
Suffix:
Gender:F
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 BEAUMONT AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:PA
Mailing Address - Zip Code:19560-1609
Mailing Address - Country:US
Mailing Address - Phone:610-929-9882
Mailing Address - Fax:
Practice Address - Street 1:1400 WASHINGTON ST
Practice Address - Street 2:STE 702
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601
Practice Address - Country:US
Practice Address - Phone:610-929-9882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001582L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000085053OtherBLUE SHIELD
PA000085053OtherBLUE SHIELD