Provider Demographics
NPI:1255341350
Name:SHAFER, DANA E (DC)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:E
Last Name:SHAFER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 FREDRICKSON PL
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-6247
Mailing Address - Country:US
Mailing Address - Phone:724-837-4559
Mailing Address - Fax:724-837-4356
Practice Address - Street 1:2030 FREDRICKSON PL
Practice Address - Street 2:RT 136 HEMPFIELD
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-9688
Practice Address - Country:US
Practice Address - Phone:724-837-4559
Practice Address - Fax:724-837-4356
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006283L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016853370003Medicaid
PA0016853370003Medicaid
U56795Medicare UPIN