Individual
MISS CHAD P SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
8705 PERIMETER PARK BLVD, SUITE 6, JACKSONVILLE, FL 32216-6344
(904) 997-1349
(904) 997-1369
Mailing address
8705 PERIMETER PARK BLVD, SUITE 6, JACKSONVILLE, FL 32216-6344
(904) 725-2286
(904) 725-4566
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH8022
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH8022
CHIROPRACTIC LICENSE
FL
Enumeration date
02/13/2006
Last updated
10/03/2007
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