Provider Demographics
NPI:1194779447
Name:HOOVER-SHEARD, SHELLEY RENEE (DC, DACBSP)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:RENEE
Last Name:HOOVER-SHEARD
Suffix:
Gender:F
Credentials:DC, DACBSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12170 TEJON ST STE 400
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-2341
Mailing Address - Country:US
Mailing Address - Phone:303-429-0011
Mailing Address - Fax:303-429-8001
Practice Address - Street 1:12170 TEJON ST STE 400
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-2341
Practice Address - Country:US
Practice Address - Phone:303-429-0011
Practice Address - Fax:303-429-8001
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4870111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU78830Medicare UPIN
COF4823Medicare PIN