Provider Demographics
NPI:1245425560
Name:BANDISH SHIRLEY, MEGAN ELIZABETH (DC)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:BANDISH SHIRLEY
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:PO BOX 435
Mailing Address - Street 2:
Mailing Address - City:CARMICHAELS
Mailing Address - State:PA
Mailing Address - Zip Code:15320-0435
Mailing Address - Country:US
Mailing Address - Phone:724-966-2070
Mailing Address - Fax:724-966-2074
Practice Address - Street 1:211 S VINE ST
Practice Address - Street 2:SUITE 104
Practice Address - City:CARMICHAELS
Practice Address - State:PA
Practice Address - Zip Code:15320-1284
Practice Address - Country:US
Practice Address - Phone:724-966-2070
Practice Address - Fax:724-966-2074
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30694111N00000X
PADC010017111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor