Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 007636-L | PA |
NPI | 1023139540 |
---|---|
Provider Name | Kristina Mcrae Shuffler |
First Address | Media, PA 19063-3517 |
Second Address | Media, PA 19063-3517 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 08/07/2007 |