Individual
BEAU SHANNON LAWYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1400 W 5TH AVE, COLUMBUS, OH 43212-2901
(614) 486-6755
(614) 486-6781
Mailing address
910 NEIL AVE, COLUMBUS, OH 43215-1333
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1915
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0914381
—
OH
Enumeration date
06/13/2006
Last updated
09/10/2010
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