| Shayna Loren Fasken, DC, MTAA | |
|
2501 W Ash St, Ste B, Columbia, MO 65203-4604 | |
| (573) 442-8959 | |
| Not Available |
| Full Name | Shayna Loren Fasken |
|---|---|
| Gender | Female |
| Speciality | Chiropractor |
| Location | 2501 W Ash St, Columbia, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851610752 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 2008001514 (Missouri) | Primary |
| Provider Name | Fasken Chiropractic And Wellness Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1780947945 PECOS PAC ID: 3678729621 Enrollment ID: O20120808000213 |
| Mailing Address | Practice Location Address |
|---|---|
| Shayna Loren Fasken, DC, MTAA 2501 W Ash St, Ste B, Columbia, MO 65203-4604 Ph: (573) 442-8959 | Shayna Loren Fasken, DC, MTAA 2501 W Ash St, Ste B, Columbia, MO 65203-4604 Ph: (573) 442-8959 |
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