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General NPI Number Information
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NPI Number | 1760978415
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Entity Type | Organization
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Legal Business Name | SHIVERS ENTERPRISES, INC
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Dates
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Enumeration Date | 07/05/2018
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Last Update Date | 07/05/2018
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Provider Practice Location Address
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Address Line | 3550 DEER RUN S
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City | PALM HARBOR
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State | FL
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Zip | 34684-3551
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Country | US
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Telephone | 727-480-2809
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Fax | 727-333-7667
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Provider Business Mailing Address
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Address Line | 3550 DEER RUN S
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City | PALM HARBOR
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State | FL
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Zip | 34684-3551
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Country | US
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Telephone | 727-480-2809
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Fax | 727-333-7667
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Authorized Official
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Title or Position | PRESIDENT
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Name | KAREN SHIVERS
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Credential | PT
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Telephone | 727-480-2809
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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 | PT7695
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License Number State | FL
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