Wyman, Shannon R.

Wyman, Shannon R. is an individual health care provider with primary practice located at 515 7Th Ave Ste 230 , Fairbanks AK 99701-4949. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Wyman, Shannon R. can be contacted via phone (907) 456-4234.

Contact Information

Primary practice address
515 7Th Ave Ste 230 Fairbanks AK 99701-4949
Phone: (907) 456-4234
Fax: (907) 451-9168
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 0408 Alaska

Profile Details

NPI number 1629125356
LBN Legal business name Wyman, Shannon R.
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2007
Last updated Jan 16th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629125356 NPPES
Alaska MEDICAID CH0408
Alaska MEDICAID 1004390

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