Provider Demographics
NPI:1356581995
Name:PARISI, SHANNON MARIE (DC)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:MARIE
Last Name:PARISI
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 1:2337 E 3395 S
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84109-3037
Mailing Address - Country:US
Mailing Address - Phone:801-337-3967
Mailing Address - Fax:
Practice Address - Street 1:880 E 3900 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-2151
Practice Address - Country:US
Practice Address - Phone:801-337-3967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-23
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8004101-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor