Provider Demographics
NPI:1508666587
Name:SHUEMATE SPECIFIC CHIROPRACTIC LLC
Entity type:Organization
Organization Name:SHUEMATE SPECIFIC CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:MASON
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:SHUEMATE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-774-1898
Mailing Address - Street 1:1079 W SUMMER AVE.
Mailing Address - Street 2:
Mailing Address - City:MINOTOLA
Mailing Address - State:NJ
Mailing Address - Zip Code:08341
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1079 W SUMMER AVE.
Practice Address - Street 2:
Practice Address - City:MINOTOLA
Practice Address - State:NJ
Practice Address - Zip Code:08341
Practice Address - Country:US
Practice Address - Phone:609-774-1898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty