Provider Demographics
NPI:1164479085
Name:SHAAR, TRICIA A (DC)
Entity Type:Individual
Prefix:DR
First Name:TRICIA
Middle Name:A
Last Name:SHAAR
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:PO BOX 270596
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-0010
Mailing Address - Country:US
Mailing Address - Phone:303-980-3009
Mailing Address - Fax:303-980-4114
Practice Address - Street 1:10288 W CHATFIELD AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-4239
Practice Address - Country:US
Practice Address - Phone:303-980-3009
Practice Address - Fax:303-980-4114
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4471111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO544418Medicare PIN
COU86026Medicare UPIN