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General NPI Number Information
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NPI Number | 1023441813
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Entity Type | Individual
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Provider Name | SHAUNA NOELCKE DPT
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Gender | Female
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Dates
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Enumeration Date | 08/15/2013
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Last Update Date | 05/10/2017
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Provider Practice Location Address
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Address Line | 400 N ERIE HWY SUITE A
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City | HAMILTON
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State | OH
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Zip | 45011-4263
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Country | US
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Telephone | 937-430-2436
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Fax |
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Provider Business Mailing Address
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Address Line | 7838 HOLLOW OAK CT
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City | WEST CHESTER
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State | OH
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Zip | 45069-5846
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Country | US
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Telephone | 937-430-2436
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 7144
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License Number State | SC
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