Provider Demographics
NPI:1023361532
Name:CLABAUGH, SHANNA R (DC)
Entity Type:Individual
Prefix:
First Name:SHANNA
Middle Name:R
Last Name:CLABAUGH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:SHANNA
Other - Middle Name:R
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:703 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:SPIRIT LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:51360-1647
Mailing Address - Country:US
Mailing Address - Phone:712-336-2626
Mailing Address - Fax:
Practice Address - Street 1:1306 18TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:SPIRIT LAKE
Practice Address - State:IA
Practice Address - Zip Code:51360-1163
Practice Address - Country:US
Practice Address - Phone:712-336-2626
Practice Address - Fax:712-336-8834
Is Sole Proprietor?:No
Enumeration Date:2012-10-22
Last Update Date:2017-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007515111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor