Shane Edward Wallace, DC
NPI 1639753239ActiveIndividual· Chiropractor· Brooklyn, MI
Chiropractor (DC) in Brooklyn, Michigan, trained at Life Chiropractic College (class of 2019). Enrolled in Medicare as practitioner - chiropractic.
Overview
| NPI | 1639753239 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DC |
| Sole proprietor | No |
| NPI issued | May 10, 2021 |
| Last updated in NPPES | May 10, 2021 |
| Certified by provider | May 10, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Chiropractor Primary | 111N00000X | 2301011096 | MI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Chiropractic (MI) |
|---|
Education and affiliations
| Medical school | Life Chiropractic College |
|---|---|
| Graduation year | 2019 |
| Medicare specialty | Chiropractic |
Medical group
- Tribe Chiropractic PLLCTecumseh, MI · 2 clinicians
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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