Provider Demographics
NPI:1619985959
Name:HILTON, SHAD ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:SHAD
Middle Name:ALAN
Last Name:HILTON
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:PO BOX 378
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:MO
Mailing Address - Zip Code:65556-0378
Mailing Address - Country:US
Mailing Address - Phone:573-765-2606
Mailing Address - Fax:
Practice Address - Street 1:120 W. MCCLURG AVE
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:MO
Practice Address - Zip Code:65556
Practice Address - Country:US
Practice Address - Phone:573-765-2606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006021424111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor