Doctor Name: | BRIAN THOMAS SHEA |
NPI Number: | 1396758835 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O. |
License Number: | 36013 |
Business Practice Address: | 777 29th St 400 Boulder, CO - 803032358 |
Business Phone Number: | 3034470022 |
Business Fax Number: | |
Mailing Address: | 777 29th St, 400 BOULDER |
State: | CO |
Postal Code: | 803032358 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/15/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204D00000X |
License Number: | 36013 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
Taxonomy Specialization: | |
Taxonomy Definition: |