Provider Demographics
NPI:1275026924
Name:LOCKHART, SHELBY R (DC)
Entity Type:Individual
Prefix:DR
First Name:SHELBY
Middle Name:R
Last Name:LOCKHART
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 1:800 COPPER RD # 3654
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:CO
Mailing Address - Zip Code:80443-9996
Mailing Address - Country:US
Mailing Address - Phone:515-333-1620
Mailing Address - Fax:970-406-5040
Practice Address - Street 1:160 E ADAMS ST STE B3
Practice Address - Street 2:
Practice Address - City:BRECKENRIDGE
Practice Address - State:CO
Practice Address - Zip Code:80424-5026
Practice Address - Country:US
Practice Address - Phone:515-333-1620
Practice Address - Fax:970-406-5040
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-07
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0008500111NN1001X, 111NX0100X, 111NX0800X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NX0100XChiropractic ProvidersChiropractorOccupational Health
No111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty