MEDICARE: STEPHEN C SHUEY D.C.

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	2417	OK

General Provider Information

NPI Number	:	1568470979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN C SHUEY D.C.

Provider Business Mailing Address
First Line	:	817 S ELM PL
Second Line	:	STE 107
City	:	BROKEN ARROW
State	:	OK
Zip	:	74012-5369
Country	:	US
Telephone Number	:	918-251-5588
Fax Number	:	918-251-5658

Provider Business Practice Location Address
First Line	:	817 S ELM PL
Second Line	:	STE 107
City	:	BROKEN ARROW
State	:	OK
Zip	:	74012-5369
Country	:	US
Telephone Number	:	918-251-5588
Fax Number	:	918-251-5658

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

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	12/19/2016

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