Individual
SHANNON R. WYMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
515 7TH AVE STE 230, FAIRBANKS, AK 99701-4949
(907) 456-4234
(907) 451-9168
Mailing address
515 7TH AVE STE 230, FAIRBANKS, AK 99701-4949
(907) 456-4234
(907) 451-9168
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0408
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004390
—
AK
05
—
CH0408
—
AK
Enumeration date
01/04/2007
Last updated
01/16/2019
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