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NPI Code Detail

MEDICARE: TERESA MAE SHIPTON LPTA

MEDICARE: TERESA MAE SHIPTON LPTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant5502000921MI

General Provider Information

NPI Number : 1073859534
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA MAE SHIPTON LPTA
Provider Business Mailing Address
First Line : 1900 S LACHANCE RD
Second Line :
City : LAKE CITY
State : MI
Zip : 49651-8022
Country : US
Telephone Number : 231-775-3081
Fax Number :
Provider Business Practice Location Address
First Line : 1900 S LACHANCE RD
Second Line :
City : LAKE CITY
State : MI
Zip : 49651-8022
Country : US
Telephone Number : 231-775-3081
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2013
Last Update Date : 01/02/2013

Similar Medicare Providers

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1649516360 — DANAY MARIE TOSSEY PTS
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1164863296 — ELIZABETH M SLACK
Practice Location Address:
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1497176440 — BRENNA CHAPMAN
Practice Location Address:
1900 S LACHANCE RD
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49651-8022
Practice Phone: 231-775-3081
Practice Fax: 231-775-7740

Directions to “ TERESA MAE SHIPTON LPTA” Practice Location

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