Provider Demographics
NPI:1114799566
Name:SHINE CHIROPRACTIC AND WELLNESS LLC
Entity Type:Organization
Organization Name:SHINE CHIROPRACTIC AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHEA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSUNA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:720-295-7756
Mailing Address - Street 1:7716 TORREY CT
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80007-7640
Mailing Address - Country:US
Mailing Address - Phone:720-646-6369
Mailing Address - Fax:
Practice Address - Street 1:4411 YATES ST UNIT 103
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80212-2450
Practice Address - Country:US
Practice Address - Phone:720-295-7756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service