Provider Demographics
NPI:1841227279
Name:SHROPSHIRE, STACY LEIGH (DC)
Entity type:Individual
Prefix:DR
First Name:STACY
Middle Name:LEIGH
Last Name:SHROPSHIRE
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 1:5286 WILLIAMSBURG WAY
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53719-1780
Mailing Address - Country:US
Mailing Address - Phone:608-274-3809
Mailing Address - Fax:608-274-3982
Practice Address - Street 1:5286 WILLIAMSBURG WAY
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53719-1780
Practice Address - Country:US
Practice Address - Phone:608-274-3809
Practice Address - Fax:608-274-3982
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3399-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38902300Medicaid