NPI 1104113935

Shasta J Ellenburg, PT

Practitioner Physical Therapist Ozark, AL

Practice location

Address: 1254 Andrews Ave, Ozark, AL 36360-3712
Phone: (334) 445-1380
Fax: (334) 445-1489
Mailing address: PO Box 949, Rome, GA 30162-0949

Registered specialties

Physical Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X Licence PTH4042 (AL)

Other Physical Therapist providers in Alabama →

Registry record

NPI: 1104113935
Entity type: Individual
Sex (as registered): Female
NPI issued: 30 Jun 2011
Record last updated: 30 Jun 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.