Provider Demographics
NPI:1558530667
Name:SHIEPIS CLINIC OF CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:SHIEPIS CLINIC OF CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KERIC
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHIEPIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-453-7733
Mailing Address - Street 1:2756 CLEVELAND AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-3392
Mailing Address - Country:US
Mailing Address - Phone:330-453-7733
Mailing Address - Fax:330-453-7821
Practice Address - Street 1:2756 CLEVELAND AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44709-3392
Practice Address - Country:US
Practice Address - Phone:330-453-7733
Practice Address - Fax:330-453-7821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1388111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0712143Medicaid
OH0712143Medicaid