Provider Demographics
NPI:1548905029
Name:SANKO, SHELBY (DC)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:SANKO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 HAMLEN RD
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-3924
Mailing Address - Country:US
Mailing Address - Phone:570-225-5135
Mailing Address - Fax:
Practice Address - Street 1:2391 BRANDERMILL BLVD STE 105
Practice Address - Street 2:
Practice Address - City:GAMBRILLS
Practice Address - State:MD
Practice Address - Zip Code:21054-1985
Practice Address - Country:US
Practice Address - Phone:410-721-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS04134111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor