Provider Demographics
NPI:1225792666
Name:HIGH PEAKS CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:HIGH PEAKS CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DREW
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:518-837-5353
Mailing Address - Street 1:6018 SENTINEL RD
Mailing Address - Street 2:
Mailing Address - City:LAKE PLACID
Mailing Address - State:NY
Mailing Address - Zip Code:12946-3649
Mailing Address - Country:US
Mailing Address - Phone:518-837-5353
Mailing Address - Fax:
Practice Address - Street 1:6018 SENTINEL RD
Practice Address - Street 2:
Practice Address - City:LAKE PLACID
Practice Address - State:NY
Practice Address - Zip Code:12946-3649
Practice Address - Country:US
Practice Address - Phone:518-837-5353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty