Provider Demographics
NPI:1891011094
Name:ZACKAROFF, SHELBY NICOLE (DC, MS)
Entity Type:Individual
Prefix:DR
First Name:SHELBY
Middle Name:NICOLE
Last Name:ZACKAROFF
Suffix:
Gender:F
Credentials:DC, MS
Other - Prefix:DR
Other - First Name:SHELBY
Other - Middle Name:NICOLE
Other - Last Name:VOJTECH ZACKAROFF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC, MS
Mailing Address - Street 1:8900 DARROW RD
Mailing Address - Street 2:SUITE H104
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-6800
Mailing Address - Country:US
Mailing Address - Phone:330-963-2273
Mailing Address - Fax:330-963-2275
Practice Address - Street 1:8900 DARROW RD
Practice Address - Street 2:SUITE H104
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-6800
Practice Address - Country:US
Practice Address - Phone:330-963-2273
Practice Address - Fax:330-963-2275
Is Sole Proprietor?:No
Enumeration Date:2010-04-13
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4045111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor