Shelton, Jared Mark

Shelton, Jared Mark is an individual health care provider with primary practice located at 45 W Center St , Soda Springs ID 83276-1530. He recently has 2 registered licenses in different health care specialties including Chiropractic Providers / Chiropractor, Chiropractic Providers / Sports Physician. Chiropractic Providers / Sports Physician is his primary health care specialty. Shelton, Jared Mark can be contacted via phone (208) 547-4518.

Contact Information

Primary practice address
45 W Center St Soda Springs ID 83276-1530
Phone: (208) 547-4518
Fax: (208) 547-4555
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X CHIA-1284 Idaho
Chiropractic Providers / Sports Physician 111NS0005X CHIA-1284 Idaho

Profile Details

NPI number 1457537862
LBN Legal business name Shelton, Jared Mark
Credentials DC, BS, CSCS
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 16th, 2008
Last updated Sep 3rd, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457537862 NPPES
Idaho MEDICAID 807952000
Idaho Other 1673568

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