MEDICARE: LARRY ALAN SHIPLEY 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	5010	AZ

General Provider Information

NPI Number	:	1164580189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARRY ALAN SHIPLEY DC

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

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

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

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	07/08/2007

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Directions to “ LARRY ALAN SHIPLEY DC” Practice Location

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