Individual
DR. SHANE DEHAVEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
393 EH CT, BRUNSWICK, GA 31520-2197
(716) 725-3538
Mailing address
393 EH CT, BRUNSWICK, GA 31520-2197
(716) 725-3538
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR009300
GA
Other
Enumeration date
04/21/2014
Last updated
04/21/2014
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