Brian R Shade, D.C. Valid NPI

Individual provider · Chiropractor · Farmingdale, NJ

NPI

1154361632

Type

Individual (Type 1)

Primary specialty

Chiropractor

Specialty group

Chiropractic Providers

Taxonomy code

111N00000X

License number

38MC00554600 (NJ)

Sex

Male

Sole proprietor

No

Enumerated

2006-06-06

Last updated

2007-07-08