Deborah L. Shaw
Individual provider Active NPI Physical Therapy Assistant · Marlette, MI
NPI 1356550867 · NPPES record last updated Mar 17, 2014
Key facts
- NPI
- 1356550867
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 5502001979 (MI)
- Practice address
- 2358 Koylette Rd
Marlette, MI 48453-9609 - Phone
- (989) 635-4842
- Fax
- (989) 635-4842
- NPI assigned
- May 21, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5502001979 | MI | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 5502001979 | MI | Yes |
Addresses
Primary practice location
2358 Koylette Rd
Marlette, MI 48453-9609
Mailing address
2358 Koylette Rd
Marlette, MI 48453-9609
Phone (989) 635-4842
Other providers in Marlette, MI
- Robert G Mutch DO PC
- Saib Isterabadi MD
- Marlene May Schank
- Selad Corporation
- Brittany Selleke
- Smith Physical Therapy and Sports Medicine
- Hayley Stamps
- Straight Imaging, PC
- Samantha Strickler
- Shannon Lee Swanson
All providers in Marlette, MI · Physical Therapy Assistant in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.