Doctor Name: | SHELLANE N SHATTUCK |
NPI Number: | 1215222492 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | 19528 |
Business Practice Address: | 145 Hazard Ave Suite B Enfield, CT - 060824521 |
Business Phone Number: | 8602652571 |
Business Fax Number: | 8602652574 |
Mailing Address: | 145 Hazard Ave, Suite B ENFIELD |
State: | CT |
Postal Code: | 060824521 |
Phone Number: | 8602652571 |
Fax Number: | 8602652574 |
NPI Enumeration Date: | 06/15/2011 |
NPI Last Update Date: | 05/29/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 19528 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |