MEDICARE: MRS. SHELLY S WEST PHYSICAL THERAPIST

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	PT 17201	FL

General Provider Information

NPI Number	:	1992914048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHELLY S WEST PHYSICAL THERAPIST

Provider Business Mailing Address
First Line	:	3774 WELLINGTON PKWY
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685
Country	:	US
Telephone Number	:	727-772-7444
Fax Number	:	727-785-7329

Provider Business Practice Location Address
First Line	:	3774 WELLINGTON PKWY
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685
Country	:	US
Telephone Number	:	727-772-7444
Fax Number	:	727-785-7329

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

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	07/08/2007

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