Provider Demographics
NPI:1629281886
Name:SHAUN WALDMAN DC INC
Entity Type:Organization
Organization Name:SHAUN WALDMAN DC INC
Other - Org Name:FOSTER CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAUN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-566-3552
Mailing Address - Street 1:1525 W WARM SPRINGS RD
Mailing Address - Street 2:STE 300
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-4315
Mailing Address - Country:US
Mailing Address - Phone:702-566-3552
Mailing Address - Fax:702-565-7787
Practice Address - Street 1:1525 W WARM SPRINGS RD
Practice Address - Street 2:STE 300
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-4315
Practice Address - Country:US
Practice Address - Phone:702-566-3552
Practice Address - Fax:702-565-7787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1003004695111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty