Provider Demographics
NPI:1063699205
Name:SHIVER, JOSEPH CHARLES (DC)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:CHARLES
Last Name:SHIVER
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 1:1611 10TH AVE W
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-3018
Mailing Address - Country:US
Mailing Address - Phone:941-721-8132
Mailing Address - Fax:941-721-8232
Practice Address - Street 1:1611 10TH AVE W
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-3018
Practice Address - Country:US
Practice Address - Phone:941-721-8132
Practice Address - Fax:941-721-8232
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 9515111N00000X
NC3697111N00000X
SC3271111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor