Provider Demographics
NPI:1326334426
Name:DECKER, SHEILA SUE (DC)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:SUE
Last Name:DECKER
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 1:3481 GULF BREEZE PKWY
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-1402
Mailing Address - Country:US
Mailing Address - Phone:850-903-1708
Mailing Address - Fax:386-463-4170
Practice Address - Street 1:3481 GULF BREEZE PKWY
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-1402
Practice Address - Country:US
Practice Address - Phone:850-903-1708
Practice Address - Fax:850-903-1708
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12796111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty