Individual
DR. MARK R SHANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1708 STAMPEDE AVE, SUITE C, CODY, WY 82414-4829
(307) 587-5591
(307) 587-4399
Mailing address
1708 STAMPEDE AVE, SUITE C, CODY, WY 82414-4829
(307) 587-5591
(307) 587-4399
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
747
WY
Other
Enumeration date
03/08/2007
Last updated
08/17/2015
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