Provider Demographics
NPI:1821041807
Name:MCGUIRE, SHAUN PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:SHAUN
Middle Name:PATRICK
Last Name:MCGUIRE
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 1:222 E FRY BLVD
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-1817
Mailing Address - Country:US
Mailing Address - Phone:520-459-1414
Mailing Address - Fax:520-459-2077
Practice Address - Street 1:222 E FRY BLVD
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-1817
Practice Address - Country:US
Practice Address - Phone:520-459-1414
Practice Address - Fax:520-459-2077
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7690111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZV08752Medicare ID - Type Unspecified