Provider Demographics
NPI:1407006372
Name:SHOOK, WILLIAM BRADLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BRADLEY
Last Name:SHOOK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18047 W CATAWBA AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-5664
Mailing Address - Country:US
Mailing Address - Phone:704-892-7772
Mailing Address - Fax:
Practice Address - Street 1:18047 W CATAWBA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-5664
Practice Address - Country:US
Practice Address - Phone:704-892-7772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3898111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor