Provider Demographics
NPI:1851347488
Name:SHEMANSKY, CHIP T (DC)
Entity Type:Individual
Prefix:DR
First Name:CHIP
Middle Name:T
Last Name:SHEMANSKY
Suffix:
Gender:M
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:PO BOX 366235
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34136-6235
Mailing Address - Country:US
Mailing Address - Phone:239-948-5727
Mailing Address - Fax:239-948-5895
Practice Address - Street 1:3501 HEALTH CENTER BLVD
Practice Address - Street 2:SUITE 2430
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-8127
Practice Address - Country:US
Practice Address - Phone:239-948-5727
Practice Address - Fax:239-948-5895
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH-8023111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL593701954OtherTAX ID
FL53933ZMedicare PIN
FLU83774Medicare UPIN