Provider Demographics
NPI:1699882050
Name:TWIT, SHAN MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:SHAN
Middle Name:MICHAEL
Last Name:TWIT
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 1:970 SUMMER ST FL 1
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5542
Mailing Address - Country:US
Mailing Address - Phone:203-276-1293
Mailing Address - Fax:
Practice Address - Street 1:970 SUMMER ST FL 1
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5542
Practice Address - Country:US
Practice Address - Phone:203-276-1293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001827111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor