Provider Demographics
NPI:1104937234
Name:MIGLORE, SHAUN R (DC)
Entity type:Individual
Prefix:DR
First Name:SHAUN
Middle Name:R
Last Name:MIGLORE
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 1:5533 E BELL RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-1228
Mailing Address - Country:US
Mailing Address - Phone:602-788-4200
Mailing Address - Fax:602-788-4208
Practice Address - Street 1:5533 E BELL RD
Practice Address - Street 2:SUITE 109
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-1228
Practice Address - Country:US
Practice Address - Phone:602-788-4200
Practice Address - Fax:602-788-4208
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7214111N00000X
AZ3903208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ70183Medicare ID - Type Unspecified