Provider Demographics
NPI:1538122387
Name:HURLEY, SHANNON KAY (DC, ATC)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:KAY
Last Name:HURLEY
Suffix:
Gender:F
Credentials:DC, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9249 S BROADWAY
Mailing Address - Street 2:UNIT 100
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-5691
Mailing Address - Country:US
Mailing Address - Phone:303-683-6868
Mailing Address - Fax:303-683-2629
Practice Address - Street 1:9249 S BROADWAY
Practice Address - Street 2:UNIT 100
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-5691
Practice Address - Country:US
Practice Address - Phone:303-683-6868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0007499111N00000X, 111N00000X
COEL2786568111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
010602012OtherBOCATC