Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC010349 | PA |
N | 111NR0400X | Rehabilitation Chiropractor | AJ010151 | PA |
NPI | 1114228673 |
---|---|
Provider Name | Joseph Michael Shuluga JR. |
First Address | Seven Fields, PA 16046-7868 |
Second Address | Seven Fields, PA 16046-7868 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2010 |
Last Update Date | 15/11/2010 |