| NPI | 1114017084 |
|---|---|
| Other Name | GARY LYMAN SHAW |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: IN 08001024) |
| Additional Taxonomies | 111NX0800X Chiropractor, Orthopedic (Licence: IN 08001024) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2007-12-04 |