Provider Demographics
NPI:1730233487
Name:SHOVER, CYNTHIA L (DC)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:L
Last Name:SHOVER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 E TEMPERANCE ST
Mailing Address - Street 2:
Mailing Address - City:ELLETTSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47429-1836
Mailing Address - Country:US
Mailing Address - Phone:812-219-8687
Mailing Address - Fax:
Practice Address - Street 1:202 E TEMPERANCE ST
Practice Address - Street 2:
Practice Address - City:ELLETTSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47429-1836
Practice Address - Country:US
Practice Address - Phone:812-219-8687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002100A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor