Individual
DR. STEVEN RAY SHOCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
16901 WRIGHT PLAZA, 183, OMAHA, NE 68130
(402) 334-0840
(402) 334-1474
Mailing address
16901 WRIGHT PLAZA, 183, OMAHA, NE 68130
(402) 334-0840
(402) 334-1474
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1004
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36645
BLUE CROSS BLUE SHIELD
NE
05
—
91177190300
—
NE
01
—
NA1072001
MEDICARE PTAN
—
Enumeration date
12/12/2006
Last updated
10/20/2008
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