MEDICARE: SHAWNDA M METZGER PTA

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	225200000X	Physical Therapy Assistant

General Provider Information

NPI Number	:	1881271799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWNDA M METZGER PTA

Provider Business Mailing Address
First Line	:	714 ELSON AVE
Second Line	:
City	:	VAN WERT
State	:	OH
Zip	:	45891-1627
Country	:	US
Telephone Number	:	419-302-1737
Fax Number	:

Provider Business Practice Location Address
First Line	:	13921 SHELL POINT PLZ
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33908-2830
Country	:	US
Telephone Number	:	800-780-1131
Fax Number	:

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

Provider Enumeration Date	:	03/26/2021
Last Update Date	:	03/26/2021

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