Jeffrey W Shaw, D.C.
Individual provider Active NPI Chiropractor · Granby, CO
NPI 1003955964 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1003955964
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1596 (CO)
- Practice address
- 60 2ND St
Granby, CO 80446-0036 - Phone
- (970) 887-3131
- Fax
- (970) 887-3913
- NPI assigned
- Feb 6, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1596 | CO | MD | Medical Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1596 | CO | Yes |
Addresses
Primary practice location
60 2ND St
Granby, CO 80446-0036
Mailing address
PO Box 36
60 2ND St
Granby, CO 80446-0036
Phone (970) 887-3131
Other providers in Granby, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.