Doctor Name: | MR. JEREMIAH M SHELTON |
NPI Number: | 1235273426 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | PT00009155 |
Business Practice Address: | 3333 Harrison Ave Nw Suite 102 Olympia, WA - 985025049 |
Business Phone Number: | 3602927245 |
Business Fax Number: | 3602927247 |
Mailing Address: | Po Box 11009, OLYMPIA |
State: | WA |
Postal Code: | 985081009 |
Phone Number: | 3603522037 |
Fax Number: | |
NPI Enumeration Date: | 02/19/2007 |
NPI Last Update Date: | 01/10/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT00009155 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
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 |