Healthcare Provider Details

I. General information

NPI: 1720027907
Provider Name (Legal Business Name): JAMES S SHEBUSKI D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2114 SCHOFIELD AVE
WESTON WI
54476-2365
US

IV. Provider business mailing address

2114 SCHOFIELD AVE
WESTON WI
54476-2365
US

V. Phone/Fax

Practice location:
  • Phone: 715-355-4224
  • Fax: 715-355-4120
Mailing address:
  • Phone: 715-355-4224
  • Fax: 715-355-4120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2131
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: