Individual
DR. SHANNON JAY SCORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
10551 165TH ST W, LAKEVILLE, MN 55044-5737
(952) 435-5300
Mailing address
10551 165TH ST W, LAKEVILLE, MN 55044-5737
(952) 435-5300
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
C2095
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
88G89SC
BCBS
FM
Enumeration date
07/19/2006
Last updated
07/08/2007
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