Individual
SHANE K WISEHART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
35 BONNIE VIEW DR, STE 3, LOS ALAMOS, NM 87547-3737
(505) 672-9774
Mailing address
35 BONNIE VIEW DR, STE 3, LOS ALAMOS, NM 87547-3737
(505) 672-9774
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1186
NM
111N00000X
Chiropractor
2943171202
UT
111N00000X
Chiropractor
5885
TX
Other
Enumeration date
08/19/2006
Last updated
02/08/2017
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