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NPI Code Detail

MEDICARE: SHELLY CONLEY LPTA

MEDICARE: SHELLY CONLEY LPTA
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 Assistant720OK

General Provider Information

NPI Number : 1093436818
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELLY CONLEY LPTA
Provider Business Mailing Address
First Line : 1186 COUNTY ROAD 1560
Second Line :
City : RUSH SPRINGS
State : OK
Zip : 73082-3038
Country : US
Telephone Number : 580-467-3077
Fax Number :
Provider Business Practice Location Address
First Line : 2150 W ELK AVE
Second Line :
City : DUNCAN
State : OK
Zip : 73533-1827
Country : US
Telephone Number : 580-251-8058
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2022
Last Update Date : 09/09/2022

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Directions to “ SHELLY CONLEY LPTA” Practice Location

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