Provider Demographics
NPI:1326099904
Name:PACIOREK, SHANNA DOREEN (DC)
Entity Type:Individual
Prefix:MRS
First Name:SHANNA
Middle Name:DOREEN
Last Name:PACIOREK
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 1:427 W HARDING RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-1746
Mailing Address - Country:US
Mailing Address - Phone:937-925-0101
Mailing Address - Fax:
Practice Address - Street 1:427 W HARDING RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-1706
Practice Address - Country:US
Practice Address - Phone:937-399-1159
Practice Address - Fax:937-399-1884
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3713111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor