Provider Demographics
NPI:1851415954
Name:GUTHRIE FAMILY CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:GUTHRIE FAMILY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:GUTHRIE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:304-594-0094
Mailing Address - Street 1:8 COBUN RDG
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-4015
Mailing Address - Country:US
Mailing Address - Phone:304-594-0094
Mailing Address - Fax:304-291-5456
Practice Address - Street 1:526 ASHEBROOKE SQ
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-4465
Practice Address - Country:US
Practice Address - Phone:304-594-0094
Practice Address - Fax:304-291-5456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV708111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001705931OtherBLUE CROSS BLUE SHIELD
WVGU4102681Medicare ID - Type Unspecified
WV001705931OtherBLUE CROSS BLUE SHIELD