Provider Demographics
NPI:1164193595
Name:SHEFFER, TODD (DC)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:
Last Name:SHEFFER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 N BYRD ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:IN
Mailing Address - Zip Code:47620-1345
Mailing Address - Country:US
Mailing Address - Phone:812-483-5974
Mailing Address - Fax:
Practice Address - Street 1:4110 CHARLOTTE AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-3706
Practice Address - Country:US
Practice Address - Phone:812-483-5974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000003434111N00000X
IN08003246A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor