Provider Demographics
NPI:1356081756
Name:SHIELDSMITH CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:SHIELDSMITH CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIELDSMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:812-371-7908
Mailing Address - Street 1:6105 HERON CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-8313
Mailing Address - Country:US
Mailing Address - Phone:812-371-7908
Mailing Address - Fax:
Practice Address - Street 1:3118 N NATIONAL RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-3169
Practice Address - Country:US
Practice Address - Phone:812-371-7908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty