Provider Demographics
NPI:1568549509
Name:SHAFFER, FAWN CHERIE (DC)
Entity Type:Individual
Prefix:DR
First Name:FAWN
Middle Name:CHERIE
Last Name:SHAFFER
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 1:565 MCELHATTAN DR
Mailing Address - Street 2:
Mailing Address - City:LOCK HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17745-8360
Mailing Address - Country:US
Mailing Address - Phone:570-748-3590
Mailing Address - Fax:570-858-5083
Practice Address - Street 1:565 MCELHATTAN DR
Practice Address - Street 2:
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745-8360
Practice Address - Country:US
Practice Address - Phone:570-748-3590
Practice Address - Fax:570-858-5083
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009689111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor