Provider Demographics
NPI:1245440932
Name:WILTON, SHELLEY A (DC)
Entity type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:A
Last Name:WILTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 B LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-1453
Mailing Address - Country:US
Mailing Address - Phone:413-250-2233
Mailing Address - Fax:413-282-0006
Practice Address - Street 1:4 LIBERTY ST # B
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-1448
Practice Address - Country:US
Practice Address - Phone:413-527-2529
Practice Address - Fax:413-282-0006
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2749111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor