| Shakley Chiropractic And Wellness Center Llc | |
|
185 Harry S Truman Pkwy Ste 100 Annapolis MD 21401-7580 | |
| (410) 263-4171 | |
| (410) 263-4275 |
| Full Name | Shakley Chiropractic And Wellness Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 185 Harry S Truman Pkwy Ste 100, Annapolis, Maryland |
| Authorized Official Name and Position | Ryan Dale Shakley (DOCTOR/OWNER) |
| Authorized Official Contact | 4102518572 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shakley Chiropractic And Wellness Center Llc 185 Harry S Truman Pkwy Ste 100 Annapolis MD 21401-7580 Ph: (410) 263-4171 | Shakley Chiropractic And Wellness Center Llc 185 Harry S Truman Pkwy Ste 100 Annapolis MD 21401-7580 Ph: (410) 263-4171 |
| NPI Number | 1164813614 |
|---|---|
| Provider Enumeration Date | 02/05/2015 |
| Last Update Date | 05/03/2022 |
| Medicare PECOS PAC ID | 7012232473 |
|---|---|
| Medicare Enrollment ID | O20150206001854 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164813614 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | S03565 (Maryland) | Primary |
| Provider Name | Ryan D Shakley |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1912151234 PECOS PAC ID: 0244391282 Enrollment ID: I20081209000263 |
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