Provider Demographics
NPI:1063557882
Name:SHANTI, SANDEE L (DC)
Entity type:Individual
Prefix:DR
First Name:SANDEE
Middle Name:L
Last Name:SHANTI
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:PO BOX 23362
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96823-3362
Mailing Address - Country:US
Mailing Address - Phone:413-320-1859
Mailing Address - Fax:
Practice Address - Street 1:63 GRANBY HTS
Practice Address - Street 2:
Practice Address - City:GRANBY
Practice Address - State:MA
Practice Address - Zip Code:01033-9722
Practice Address - Country:US
Practice Address - Phone:413-320-1859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1067111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor