Provider Demographics
NPI:1679556443
Name:TUREK-SHAY, LISA ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:ANN
Last Name:TUREK-SHAY
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 1:308 KELLER AVE N
Mailing Address - Street 2:
Mailing Address - City:AMERY
Mailing Address - State:WI
Mailing Address - Zip Code:54001-1042
Mailing Address - Country:US
Mailing Address - Phone:715-268-6210
Mailing Address - Fax:715-268-6211
Practice Address - Street 1:308 KELLER AVE N
Practice Address - Street 2:
Practice Address - City:AMERY
Practice Address - State:WI
Practice Address - Zip Code:54001-1042
Practice Address - Country:US
Practice Address - Phone:715-268-6210
Practice Address - Fax:715-268-6211
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3325111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38891800Medicaid
WI38891800Medicaid