Provider Demographics
NPI:1316510274
Name:FORRESTER, SHELBY (DC)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:FORRESTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10629 MONROVIA DR APT 210
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5597
Mailing Address - Country:US
Mailing Address - Phone:734-770-0220
Mailing Address - Fax:
Practice Address - Street 1:6580 OLD MONROE RD STE A
Practice Address - Street 2:
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-5362
Practice Address - Country:US
Practice Address - Phone:704-225-8686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5371111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor