Healthcare Provider Details

I. General information

NPI: 1619932431
Provider Name (Legal Business Name): SHAWN MICHAEL MEYER D.C., C.C.N., PMMTP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4110 N SCOTTSDALE RD STE 215
SCOTTSDALE AZ
85251-3635
US

IV. Provider business mailing address

4110 N SCOTTSDALE RD STE 215
SCOTTSDALE AZ
85251-3635
US

V. Phone/Fax

Practice location:
  • Phone: 480-609-4244
  • Fax:
Mailing address:
  • Phone: 480-609-4244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number7589
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number4276
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: