Provider Demographics
NPI:1316078330
Name:SHOEMAKER, JOEL ALLEN (DC)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:ALLEN
Last Name:SHOEMAKER
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 1:310 GALLERY DR APT 302
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:NC
Mailing Address - Zip Code:28390-9824
Mailing Address - Country:US
Mailing Address - Phone:954-296-2059
Mailing Address - Fax:
Practice Address - Street 1:BUILDING 1722-C TAGATAY DR
Practice Address - Street 2:
Practice Address - City:FORT LIBERTY
Practice Address - State:NC
Practice Address - Zip Code:28310-1706
Practice Address - Country:US
Practice Address - Phone:910-643-2028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6045111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22441Medicare ID - Type Unspecified