Provider Demographics
NPI:1548443443
Name:RICE, SHAD C (DC)
Entity type:Individual
Prefix:DR
First Name:SHAD
Middle Name:C
Last Name:RICE
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 1:235 N RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WV
Mailing Address - Zip Code:26452-1620
Mailing Address - Country:US
Mailing Address - Phone:304-997-8450
Mailing Address - Fax:304-997-8452
Practice Address - Street 1:235 N RIVER AVE
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WV
Practice Address - Zip Code:26452-1620
Practice Address - Country:US
Practice Address - Phone:304-997-8450
Practice Address - Fax:304-997-8452
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV875111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV4227411Medicare PIN
WVWV5054E336Medicare PIN