Provider Demographics
NPI:1215279351
Name:MICHAEL SHELL CHIROPRACTIC LLC
Entity type:Organization
Organization Name:MICHAEL SHELL CHIROPRACTIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SHELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:251-968-2225
Mailing Address - Street 1:27250 PERDIDO BEACH BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ORANGE BEACH
Mailing Address - State:AL
Mailing Address - Zip Code:36561-3205
Mailing Address - Country:US
Mailing Address - Phone:251-968-2225
Mailing Address - Fax:
Practice Address - Street 1:27250 PERDIDO BEACH BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:ORANGE BEACH
Practice Address - State:AL
Practice Address - Zip Code:36561-3205
Practice Address - Country:US
Practice Address - Phone:251-968-2225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2226111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty