Provider Demographics
NPI:1609542257
Name:SHELBY, SKY L II (DC)
Entity Type:Individual
Prefix:DR
First Name:SKY
Middle Name:L
Last Name:SHELBY
Suffix:II
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 1:47 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30512-8922
Mailing Address - Country:US
Mailing Address - Phone:706-781-6732
Mailing Address - Fax:
Practice Address - Street 1:47 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:BLAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30512-8922
Practice Address - Country:US
Practice Address - Phone:706-781-6732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010591111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty