Shirley Arnold, PTA – Physical Therapy Assistant

Key facts

NPI: 1861684409
Entity type: Individual (NPI type 1)
Primary specialty: Physical Therapy Assistant 225200000X
License: PTA18906 (FL)
Practice address: 577 Brookmeade Dr
Crestview, FL 32539-6029
Phone: (850) 682-7466
Fax: (850) 682-6591
NPI assigned: Aug 17, 2007
Sex: Female
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Crestview Physical Therapy Inc Physical Therapist · Crestview, FL · NPI 1295784668

NPD (past) PHYSICAL THERAPY ASSISTANT

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
PTA18906	FL	MD	Physical Therapy Assistant

Practice roles

Organization	Specialty	Status	New patients
Crestview Physical Therapy Inc	Physical Therapy Assistant	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physical Therapy Assistant	225200000X	PTA18906	FL	Yes

Addresses

Primary practice location

577 Brookmeade Dr
Crestview, FL 32539-6029

Mailing address

PO Box 2010
Crestview, FL 32536-8010
Phone (850) 682-7466

Other identifiers

Identifier	Type	State	Issuer
PTA18906	Other	FL	STATE LICENSE

Other providers in Crestview, FL

All providers in Crestview, FL · Physical Therapy Assistant in Florida

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2007. 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.

Verify at the official NPI Registry.