MEDICARE: PARU SHAH NELSON

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		CA

General Provider Information

NPI Number	:	1881173474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PARU SHAH NELSON

Provider Business Mailing Address
First Line	:	1015 THACKERY LN
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60564-3142
Country	:	US
Telephone Number	:	630-392-8242
Fax Number	:

Provider Business Practice Location Address
First Line	:	2233 ACADEMY PL STE 201
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-1679
Country	:	US
Telephone Number	:	719-597-0822
Fax Number	:

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

Provider Enumeration Date	:	08/14/2018
Last Update Date	:	10/02/2024

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Directions to “ PARU SHAH NELSON ” Practice Location

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