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NPI Code Detail

MEDICARE: JOSEPH LOUIS SHAFFO P.T.

MEDICARE:   JOSEPH LOUIS SHAFFO  P.T.
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
12251X0800XOrthopedic Physical TherapistPT005982LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1336453OTHERPAHEALTH ASSURANCE PENNSYL
20005691425OTHERPAAETNA

General Provider Information

NPI Number : 1558491126
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH LOUIS SHAFFO P.T.
Provider Business Mailing Address
First Line : PO BOX 445
Second Line :
City : HARRISON CITY
State : PA
Zip : 15636-0445
Country : US
Telephone Number : 724-744-0499
Fax Number : 412-374-7294
Provider Business Practice Location Address
First Line : 515 PLEASANT VALLEY RD
Second Line :
City : TRAFFORD
State : PA
Zip : 15085-2702
Country : US
Telephone Number : 724-744-0499
Fax Number : 412-374-7294
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2007
Last Update Date : 07/08/2007

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Directions to “ JOSEPH LOUIS SHAFFO P.T.” Practice Location

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