Provider Demographics
NPI:1750482972
Name:STINTON, SHAWN DAVID (DC)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:DAVID
Last Name:STINTON
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 1:517 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:BELLE FOURCHE
Mailing Address - State:SD
Mailing Address - Zip Code:57717-1415
Mailing Address - Country:US
Mailing Address - Phone:605-892-4909
Mailing Address - Fax:605-892-4909
Practice Address - Street 1:517 GRANT ST
Practice Address - Street 2:
Practice Address - City:BELLE FOURCHE
Practice Address - State:SD
Practice Address - Zip Code:57717-1415
Practice Address - Country:US
Practice Address - Phone:605-892-4909
Practice Address - Fax:605-892-4909
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD802111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7600953Medicaid
SD100294Medicare ID - Type Unspecified