Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 4870 | CO |
NPI | 1194779447 |
---|---|
Provider Name | Shelley Renee Hoover-Sheard |
First Address | Westminster, CO 80234-2980 |
Second Address | Westminster, CO 80234-2980 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2006 |
Last Update Date | 09/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U78830 | (02) | CO |