Healthcare Provider Details

I. General information

NPI: 1275195489
Provider Name (Legal Business Name): SHELBY HAYES PARRISH PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2019
Last Update Date: 07/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4820 NEWBERRY RD
GAINESVILLE FL
32607-2249
US

IV. Provider business mailing address

2000 SW 16TH ST APT 9
GAINESVILLE FL
32608-1437
US

V. Phone/Fax

Practice location:
  • Phone: 352-373-2116
  • Fax:
Mailing address:
  • Phone: 352-514-8762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT34779
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: