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General NPI Number Information
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NPI Number | 1881707305
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Entity Type | Individual
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Provider Name | KATHY J SHUFFLEBARGER P.T.
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Gender | Female
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 01/13/2011
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Provider Practice Location Address
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Address Line | 1215 E ORANGE ST
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City | LAKELAND
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State | FL
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Zip | 33801-5762
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Country | US
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Telephone | 863-802-3800
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Fax | 863-802-0480
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Provider Business Mailing Address
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Address Line | 1215 E ORANGE ST
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City | LAKELAND
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State | FL
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Zip | 33801-5762
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Country | US
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Telephone | 863-802-3800
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Fax | 863-802-0480
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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 | PT1944
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number | PT1944
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | PT0001944
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License Number State | FL
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