Provider Demographics
NPI:1699711960
Name:SHAFFER, ROBERT WRIGHTSMEN (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WRIGHTSMEN
Last Name:SHAFFER
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 1:713 TAYWOOD RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45322-1822
Mailing Address - Country:US
Mailing Address - Phone:937-558-1256
Mailing Address - Fax:937-558-1273
Practice Address - Street 1:713 TAYWOOD RD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45322-1822
Practice Address - Country:US
Practice Address - Phone:937-558-1256
Practice Address - Fax:937-558-1273
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1345111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U12911Medicare UPIN
OHSH0672403Medicare ID - Type Unspecified