Provider Demographics
NPI:1588211965
Name:SHAUN N. PRICE DC, LLC
Entity Type:Organization
Organization Name:SHAUN N. PRICE DC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAUN
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:229-942-9511
Mailing Address - Street 1:152 ROBERT B LEE DR
Mailing Address - Street 2:#31
Mailing Address - City:LEESBURG
Mailing Address - State:GA
Mailing Address - Zip Code:31763
Mailing Address - Country:US
Mailing Address - Phone:229-436-1191
Mailing Address - Fax:
Practice Address - Street 1:1477 US HIGHWAY 19 S
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:GA
Practice Address - Zip Code:31763-4868
Practice Address - Country:US
Practice Address - Phone:229-436-1191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty