Provider Demographics
NPI:1801421672
Name:DURBIN, SHAYNE MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:SHAYNE
Middle Name:MICHAEL
Last Name:DURBIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3002 ALPINE DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-0351
Mailing Address - Country:US
Mailing Address - Phone:406-366-2062
Mailing Address - Fax:
Practice Address - Street 1:2110 OVERLAND AVE STE 103
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6440
Practice Address - Country:US
Practice Address - Phone:406-366-2062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-11
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTCHI-CHI-LIC-6168111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor