Provider Demographics
NPI:1669492831
Name:SHUEY, RICH WILEY (DC)
Entity Type:Individual
Prefix:DR
First Name:RICH
Middle Name:WILEY
Last Name:SHUEY
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 1:14647 MONO WAY
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-9220
Mailing Address - Country:US
Mailing Address - Phone:209-770-5844
Mailing Address - Fax:209-532-4913
Practice Address - Street 1:14647 MONO WAY
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-9220
Practice Address - Country:US
Practice Address - Phone:209-770-5844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23590111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0235900Medicare PIN