Provider Demographics
NPI:1376917567
Name:DUNCAN, SHARLYSSA ELINE
Entity Type:Individual
Prefix:
First Name:SHARLYSSA
Middle Name:ELINE
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 MAIN STREET
Mailing Address - Street 2:ACTIVE CARE FAMILY CHIROPRACTIC
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MT
Mailing Address - Zip Code:59870
Mailing Address - Country:US
Mailing Address - Phone:406-777-1048
Mailing Address - Fax:406-777-1038
Practice Address - Street 1:212 MAIN STREET
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MT
Practice Address - Zip Code:59870
Practice Address - Country:US
Practice Address - Phone:406-777-1048
Practice Address - Fax:406-777-1038
Is Sole Proprietor?:No
Enumeration Date:2015-11-25
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist