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Individual

DR. KEVIN J SHANNAN

Active
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Individual

DR. KEVIN J SHANNAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1293
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000203896
UNICARE
OH
01
—
1293
NGS
OH
05
—
2274319
—
OH
01
—
311201162-00
WORKERS' COMPENSATION
OH
01
—
311549745-014
KLAIS & CO.
OH
01
—
4253296
AETNA
OH
Enumeration date
07/17/2006
Last updated
10/12/2007
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