MEDICARE: SHIPLEY CHIROPRACTIC PC

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

General Provider Information

NPI Number	:	1053475756
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHIPLEY CHIROPRACTIC PC

Provider Business Mailing Address
First Line	:	2292 W MAGEE RD
Second Line	:	SUITE 170
City	:	TUCSON
State	:	AZ
Zip	:	85742-4329
Country	:	US
Telephone Number	:	520-797-2922
Fax Number	:	520-742-0732

Provider Business Practice Location Address
First Line	:	2292 W MAGEE RD
Second Line	:	SUITE 170
City	:	TUCSON
State	:	AZ
Zip	:	85742-4301
Country	:	US
Telephone Number	:	520-797-2922
Fax Number	:	520-742-0732

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LARRY ALAN SHIPLEY
Credential	:	DC
Telephone Number	:	520-797-2922

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	06/02/2008

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