Provider Demographics
NPI:1477708337
Name:SKY L SHELBY INCORPORATED
Entity Type:Organization
Organization Name:SKY L SHELBY INCORPORATED
Other - Org Name:SHELBY CHIROPRACTIC OFFICES, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SKY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SHELBY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:513-521-4333
Mailing Address - Street 1:8221 COLERAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-3922
Mailing Address - Country:US
Mailing Address - Phone:513-521-4333
Mailing Address - Fax:513-521-4868
Practice Address - Street 1:8221 COLERAIN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-3922
Practice Address - Country:US
Practice Address - Phone:513-521-4333
Practice Address - Fax:513-521-4868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1382111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0712081Medicaid
OHT82010Medicare UPIN
OH0712081Medicaid