Shelley Lynn Carlson, D.C.
Individual provider Active NPI Chiropractor · De Witt, IA
NPI 1104842673 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104842673
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 06811 (IA)
- Practice address
- 602 12TH St
De Witt, IA 52742-1124 - Phone
- (563) 659-8155
- NPI assigned
- Jul 15, 2006
- Sex
- Female
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 06811 | IA | Yes |
Addresses
Primary practice location
602 12TH St
De Witt, IA 52742-1124
Mailing address
1101 Springbrook LN
De Witt, IA 52742-1066
Phone (563) 659-2171
Other providers in De Witt, IA
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.