MEDICARE: ERIN SHAW

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	2251X0800X	Orthopedic Physical Therapist	83513582401	UT

General Provider Information

NPI Number	:	1770821100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN SHAW

Provider Business Mailing Address
First Line	:	6300 MCCARRAN ST. APT. 1027
Second Line	:
City	:	NORTH LAS VEGAS
State	:	UT
Zip	:	89081-8117
Country	:	US
Telephone Number	:	801-633-6490
Fax Number	:

Provider Business Practice Location Address
First Line	:	6300 MCCARRAN ST UNIT 1027
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-8134
Country	:	US
Telephone Number	:	801-633-6490
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2013
Last Update Date	:	01/18/2013

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Directions to “ ERIN SHAW ” Practice Location

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