Shelby Bullock, PTA
Individual provider Active NPI Physical Therapy Assistant · Warrensburg, MO
NPI 1376115147 · NPPES record last updated Jul 12, 2021
Key facts
- NPI
- 1376115147
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2016037538 (MO)
- Practice address
- 1300 Veterans Rd
Warrensburg, MO 64093-8294 - Phone
- (660) 543-5064
- NPI assigned
- Jul 12, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 2016037538 | MO | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2016037538 | MO | Yes |
Addresses
Primary practice location
1300 Veterans Rd
Warrensburg, MO 64093-8294
Mailing address
800 S Main St
Clinton, MO 64735-2624
Phone (660) 525-3028
Other names
- Shelby Williams
Other providers in Warrensburg, MO
- Pamela Pitman Brown
- David F Brummel
- Alissa Marie Bruner
- Ryan Douglas Bryson
- Sydnee Bseiso
- Lauren Ashley Bunting
- Kelsey A Burden
- Jessica Bailie Burk
- Haley Burnside
- Karen Caldwell
All providers in Warrensburg, MO · Physical Therapy Assistant in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2021. 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.