Doctor Name: | SHELLY CHILES |
NPI Number: | 1316258783 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | PT25570 |
Business Practice Address: | 501 6th Avenue South St. Petersburg, FL - 33701 |
Business Phone Number: | 7278987451 |
Business Fax Number: | |
Mailing Address: | 1608 W Washington St, LINCOLN |
State: | NE |
Postal Code: | 68522 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/30/2010 |
NPI Last Update Date: | 06/30/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251P0200X |
License Number: | PT25570 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |