Provider Demographics
NPI:1427582170
Name:DUNCAN, SHAWN KURTIS (DC)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:KURTIS
Last Name:DUNCAN
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 1:1611 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-7905
Mailing Address - Country:US
Mailing Address - Phone:309-517-6486
Mailing Address - Fax:
Practice Address - Street 1:1611 5TH AVE
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-7905
Practice Address - Country:US
Practice Address - Phone:309-517-6486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.012794111N00000X
IA074677111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor