Provider Demographics
NPI:1902025703
Name:IWO, SHOYE (CHIROPRACTOR DC)
Entity Type:Individual
Prefix:MR
First Name:SHOYE
Middle Name:
Last Name:IWO
Suffix:
Gender:M
Credentials:CHIROPRACTOR DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8203 HELLMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-2531
Mailing Address - Country:US
Mailing Address - Phone:626-288-0700
Mailing Address - Fax:626-570-9566
Practice Address - Street 1:8203 HELLMAN AVE
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-2531
Practice Address - Country:US
Practice Address - Phone:626-288-0700
Practice Address - Fax:626-570-9566
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 10198111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC10198Medicare ID - Type Unspecified