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Contact Information

SHAWN D WANDERAAS, DC
1134 CHURCH ROAD
SOUTHAVEN, MS38671
 Phone: 662-393-4848
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Chiropractor

111N00000X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for SHAWN D WANDERAAS · (Male)

NPI Number 1669790523
Status Active
Credentials DC (Doctor of Chiropractic)
Entity Individual
Enumeration date 05/17/2010
Last updated 03/05/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • MS License # 1201
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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