Provider Demographics
NPI:1548289952
Name:SHINE, WILLIAM F JR (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:F
Last Name:SHINE
Suffix:JR
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 1:298 OLD ROUTE 30
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-7035
Mailing Address - Country:US
Mailing Address - Phone:724-834-0389
Mailing Address - Fax:724-834-0390
Practice Address - Street 1:298 OLD ROUTE 30
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-7035
Practice Address - Country:US
Practice Address - Phone:724-834-0389
Practice Address - Fax:724-834-0390
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009205111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1608779OtherHIGHMARK BLUE CROSS
PA2286478000OtherINDEPENDENCE BLUE
PA241120OtherHEALTH ASSURANCE
PA1608779OtherHIGHMARK BLUE CROSS
PA079500Medicare ID - Type Unspecified