Provider Demographics
NPI:1700061991
Name:SHAW, ABEL JONATHAN (DC)
Entity type:Individual
Prefix:DR
First Name:ABEL
Middle Name:JONATHAN
Last Name:SHAW
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2555 BERKSHIRE PKWY
Mailing Address - Street 2:SUITE F
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-4646
Mailing Address - Country:US
Mailing Address - Phone:515-987-6332
Mailing Address - Fax:515-978-6455
Practice Address - Street 1:2555 BERKSHIRE PKWY
Practice Address - Street 2:SUITE F
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-4646
Practice Address - Country:US
Practice Address - Phone:515-987-6332
Practice Address - Fax:515-978-6455
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA007096111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor