Martin, Shane G
Martin, Shane G is an sole proprietor health care provider with primary practice located at 3800 S Moorland Rd , New Berlin WI 53151-5226. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Martin, Shane G can be contacted via phone (262) 271-1505.Contact Information
Primary practice address
3800 S Moorland Rd
New Berlin WI 53151-5226
Phone: (262) 271-1505
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 5624-12 | Wisconsin |
Profile Details
| NPI number | 1679168637 |
|---|---|
| LBN Legal business name | Martin, Shane G |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 2nd, 2021 |
| Last updated | Sep 18th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679168637 | NPPES |
| Wisconsin | MEDICAID | 85-1974635 |
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