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NPI Code Detail

MEDICARE: SHELBY CUFFLE

MEDICARE: SHELBY CUFFLE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant160008985IL

General Provider Information

NPI Number : 1073243747
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELBY CUFFLE
Provider Business Mailing Address
First Line : 103 W EDGEWOOD AVE
Second Line :
City : EFFINGHAM
State : IL
Zip : 62401-2973
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 701 SHADWELL AVE
Second Line :
City : FLORA
State : IL
Zip : 62839-2310
Country : US
Telephone Number : 618-662-8361
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2022
Last Update Date : 06/14/2022

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Directions to “ SHELBY CUFFLE ” Practice Location

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