Individual
FREDERICK KNIGHT SHEPPARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2649 BAY SETTLEMENT RD, GREEN BAY, WI 54311-7328
(906) 370-8335
Mailing address
2649 BAY SETTLEMENT ROAD, GREEN BAY, WI 54311
(906) 370-8335
Taxonomy
Speciality
Code
Description
License number
State
111NI0013X
Independent Medical Examiner Chiropractor
1883
WI
111NI0013X
Independent Medical Examiner Chiropractor
2301005616
MI
111NS0005X
Sports Physician Chiropractor
1883
WI
111NS0005X
Sports Physician Chiropractor
2301005616
MI
111NX0800X
Orthopedic Chiropractor
Primary
1883
WI
111NX0800X
Orthopedic Chiropractor
2301005616
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E30003847
—
WI
Enumeration date
11/29/2012
Last updated
11/29/2012
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