Provider Demographics
NPI:1649418690
Name:SHUMWAY WELLNESS CENTER INC
Entity Type:Organization
Organization Name:SHUMWAY WELLNESS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUMWAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-640-9893
Mailing Address - Street 1:3079 E. COMMERCIAL BLVD.
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FT. LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308
Mailing Address - Country:US
Mailing Address - Phone:954-640-9893
Mailing Address - Fax:954-200-7809
Practice Address - Street 1:3079 E. COMMERCIAL BLVD.
Practice Address - Street 2:SUITE 201
Practice Address - City:FT. LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4311
Practice Address - Country:US
Practice Address - Phone:954-640-9893
Practice Address - Fax:954-200-7809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-29
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9337111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty