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General NPI Number Information
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NPI Number | 1689920829
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Entity Type | Individual
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Provider Name | TIFFANY C SHIPP PT, DSCPT, OCS, COMT
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Gender | Female
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Dates
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Enumeration Date | 07/25/2012
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Last Update Date | 09/11/2018
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Provider Practice Location Address
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Address Line | 720 CROSS POINTE RD
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City | GAHANNA
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State | OH
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Zip | 43230-6685
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Country | US
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Telephone | 614-626-9644
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Fax |
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Provider Business Mailing Address
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Address Line | 210 STONEGATE CIR
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City | COLUMBUS
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State | OH
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Zip | 43230-7034
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Country | US
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Telephone | 614-570-1869
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Fax | 773-907-3510
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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 | PT.012821
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License Number State | OH
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