Provider Demographics
NPI:1376860817
Name:SHATEK, JOY GERRI (LMT)
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:GERRI
Last Name:SHATEK
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 S LOCUST AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAMPTON
Mailing Address - State:IA
Mailing Address - Zip Code:50659-2138
Mailing Address - Country:US
Mailing Address - Phone:641-229-0160
Mailing Address - Fax:
Practice Address - Street 1:205 S LOCUST AVE
Practice Address - Street 2:
Practice Address - City:NEW HAMPTON
Practice Address - State:IA
Practice Address - Zip Code:50659-2138
Practice Address - Country:US
Practice Address - Phone:641-229-0160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA005450175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath