Provider Demographics
NPI:1811037823
Name:WILLIAM SHAWN MCLEAN D.C.,P.C.
Entity Type:Organization
Organization Name:WILLIAM SHAWN MCLEAN D.C.,P.C.
Other - Org Name:BACK IN ACTION CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:SHAWN
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-243-5566
Mailing Address - Street 1:1001 N 5TH ST
Mailing Address - Street 2:#A
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501
Mailing Address - Country:US
Mailing Address - Phone:970-243-5566
Mailing Address - Fax:970-241-7413
Practice Address - Street 1:1001 N 5TH ST
Practice Address - Street 2:#A
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-7538
Practice Address - Country:US
Practice Address - Phone:970-243-5566
Practice Address - Fax:970-241-7413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4389111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO47183Medicare ID - Type Unspecified