Provider Demographics
NPI:1215299748
Name:SHAWN DUGAN CHIROPRACTIC CLINIC LLC
Entity type:Organization
Organization Name:SHAWN DUGAN CHIROPRACTIC CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR./OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:928-775-9200
Mailing Address - Street 1:8521 E FLORENTINE RD STE D
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-8954
Mailing Address - Country:US
Mailing Address - Phone:928-775-9200
Mailing Address - Fax:928-772-9046
Practice Address - Street 1:8521 E FLORENTINE RD STE D
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-8954
Practice Address - Country:US
Practice Address - Phone:928-775-9200
Practice Address - Fax:928-772-9046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-11
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty