Healthcare Provider Details

I. General information

NPI: 1255347282
Provider Name (Legal Business Name): ERIC SCOTT SHOOK D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 09/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1511 NORTHWEST BLVD
NEWTON NC
28658-3757
US

IV. Provider business mailing address

1511 NORTHWEST BLVD
NEWTON NC
28658-3757
US

V. Phone/Fax

Practice location:
  • Phone: 828-464-5655
  • Fax: 828-464-9969
Mailing address:
  • Phone: 828-464-5655
  • Fax: 828-464-9969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number1839
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number1534
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: