Provider Demographics
NPI:1497309066
Name:SHIPLEY CHIROPRACTIC LTD
Entity Type:Organization
Organization Name:SHIPLEY CHIROPRACTIC LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:B
Authorized Official - Last Name:SHIPLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:618-931-2001
Mailing Address - Street 1:2502 PONTOON RD
Mailing Address - Street 2:
Mailing Address - City:GRANITE CITY
Mailing Address - State:IL
Mailing Address - Zip Code:62040-4149
Mailing Address - Country:US
Mailing Address - Phone:618-931-2001
Mailing Address - Fax:618-931-6440
Practice Address - Street 1:2502 PONTOON RD
Practice Address - Street 2:
Practice Address - City:GRANITE CITY
Practice Address - State:IL
Practice Address - Zip Code:62040-4149
Practice Address - Country:US
Practice Address - Phone:618-931-2001
Practice Address - Fax:618-931-6440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-31
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty