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General NPI Number Information
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NPI Number | 1861065013
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Entity Type | Individual
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Provider Name | NEIL FRANCIS SHAW DPT
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Gender | Male
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Dates
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Enumeration Date | 07/23/2021
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 2718 US HIGHWAY 52 W STE C
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City | WEST LAFAYETTE
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State | IN
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Zip | 47906-5529
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Country | US
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Telephone | 765-237-3508
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Fax | 765-250-4989
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Provider Business Mailing Address
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Address Line | 790 REMINGTON BLVD
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City | BOLINGBROOK
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State | IL
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Zip | 60440-4909
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Country | US
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Telephone |
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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 | 1346973
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT019373
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | IN
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