Organization
DR. SHAY RIDGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAY DAVID RIDGE D.C. (OWNER OPERATOR CHIROPRACTOR)
(727) 581-7429
Entity
Organization
Contact information
Practice address
405 SEMINOLE BLVD, LARGO, FL 33770-3620
(727) 581-7429
(727) 581-3199
Mailing address
405 SEMINOLE BLVD, LARGO, FL 33770-3620
(727) 581-7429
(727) 581-3199
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH10568
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HE005Z
MEDICARE PTAN
FL
Enumeration date
09/01/2015
Last updated
09/01/2015
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