MEDICARE: WENDY SHAFFER PT

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
1	225100000X	Physical Therapist	PT012474	PA

General Provider Information

NPI Number	:	1275549743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY SHAFFER PT

Provider Business Mailing Address
First Line	:	2268 FOREST HILLS DR
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17112-1004
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	927 E MAIN ST
Second Line	:
City	:	MOUNT JOY
State	:	PA
Zip	:	17552-9546
Country	:	US
Telephone Number	:	412-856-1911
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	07/08/2007

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