Provider Demographics
NPI:1639475981
Name:HANDSCHUG, SHAWNA STUART (DC)
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:STUART
Last Name:HANDSCHUG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:WILLITS
Mailing Address - State:CA
Mailing Address - Zip Code:95490-3422
Mailing Address - Country:US
Mailing Address - Phone:612-203-3722
Mailing Address - Fax:
Practice Address - Street 1:750A CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WILLITS
Practice Address - State:CA
Practice Address - Zip Code:95490-3938
Practice Address - Country:US
Practice Address - Phone:612-203-3722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-03
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32011111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor