Provider Demographics
NPI:1629893185
Name:SHULL CHIROPRACTIC LLC
Entity type:Organization
Organization Name:SHULL CHIROPRACTIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:REYNOLDS
Authorized Official - Last Name:SHULL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:336-239-8670
Mailing Address - Street 1:89 STATE ROUTE 101A STE 3
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-2290
Mailing Address - Country:US
Mailing Address - Phone:603-673-0010
Mailing Address - Fax:
Practice Address - Street 1:89 STATE ROUTE 101A STE 3
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031-2290
Practice Address - Country:US
Practice Address - Phone:603-673-0010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-20
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty