MEDICARE: SHANLYN MARIE NEWMAN DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	4686	AZ

General Provider Information

NPI Number	:	1043218969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANLYN MARIE NEWMAN DC

Provider Business Mailing Address
First Line	:	266 W 3RD PL
Second Line	:	SUITE 1
City	:	MESA
State	:	AZ
Zip	:	85201-6578
Country	:	US
Telephone Number	:	480-835-1174
Fax Number	:	480-835-1130

Provider Business Practice Location Address
First Line	:	266 W 3RD PL
Second Line	:	SUITE 1
City	:	MESA
State	:	AZ
Zip	:	85201-6578
Country	:	US
Telephone Number	:	480-835-1174
Fax Number	:	480-835-1130

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	05/02/2012

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Directions to “ SHANLYN MARIE NEWMAN DC” Practice Location

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