Provider Demographics
NPI:1952878597
Name:SHIRLEY, CORIN (CO)
Entity Type:Individual
Prefix:MS
First Name:CORIN
Middle Name:
Last Name:SHIRLEY
Suffix:
Gender:F
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 OWENS ST STE 115
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158-2338
Mailing Address - Country:US
Mailing Address - Phone:415-476-1788
Mailing Address - Fax:
Practice Address - Street 1:1500 OWENS ST STE 115
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158-2338
Practice Address - Country:US
Practice Address - Phone:415-476-1788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO005858OtherAMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS, PROSTHETICS & PEDORTHICS, INC