MEDICARE: SHP PHYSICAL THERAPY, LLC.

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
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1497147730
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHP PHYSICAL THERAPY, LLC.

Provider Business Mailing Address
First Line	:	4 HARVARD CIR
Second Line	:	SUITE 700
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-1991
Country	:	US
Telephone Number	:	561-684-9200
Fax Number	:	561-684-9202

Provider Business Practice Location Address
First Line	:	4 HARVARD CIR
Second Line	:	SUITE 700
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-1991
Country	:	US
Telephone Number	:	561-684-9200
Fax Number	:	561-684-9202

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RICHARD KEVIN OBRIEN
Credential	:	DC
Telephone Number	:	561-684-9200

Provider Enumeration Date	:	02/24/2015
Last Update Date	:	02/24/2015

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