Provider Demographics
NPI:1013365709
Name:DELGADO RIVERA, SHIRLEY MARIE (DC)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:MARIE
Last Name:DELGADO RIVERA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19628 THORNRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44135-1046
Mailing Address - Country:US
Mailing Address - Phone:787-504-1429
Mailing Address - Fax:
Practice Address - Street 1:24700 CENTER RIDGE RD STE G70
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5636
Practice Address - Country:US
Practice Address - Phone:162-426-1552
Practice Address - Fax:216-242-6507
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-02
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4628111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor