Organization
D J SHIRLEY DC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID J SHIRLEY D.C. (PRESIDENT)
(574) 522-9740
Entity
Organization
Contact information
Practice address
2707 TOLEDO RD STE I, ELKHART, IN 46516-5773
(574) 522-9740
(574) 522-9740
Mailing address
2707 TOLEDO RD STE I, ELKHART, IN 46516-5773
(574) 522-9740
(574) 522-9740
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
51000278
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000092311
ANTHEM BCBS
IN
05
—
200155790-A
—
IN
Enumeration date
03/29/2007
Last updated
01/14/2016
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