Provider Demographics
NPI:1437280427
Name:SHORE, GEORGE FRANKLIN (DC)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:FRANKLIN
Last Name:SHORE
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:PO BOX 78
Mailing Address - Street 2:
Mailing Address - City:SAINT PARIS
Mailing Address - State:OH
Mailing Address - Zip Code:43072-0078
Mailing Address - Country:US
Mailing Address - Phone:937-663-0669
Mailing Address - Fax:888-244-1959
Practice Address - Street 1:400 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SAINT PARIS
Practice Address - State:OH
Practice Address - Zip Code:43072-9749
Practice Address - Country:US
Practice Address - Phone:937-663-0669
Practice Address - Fax:888-244-1959
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2010111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0229569Medicaid
OHU49042Medicare UPIN
OHSHO759242Medicare ID - Type Unspecified