NPI 1346660370

Shane Wallen

Practitioner Physical Therapy Assistant Warsaw, IN

Practice location

Address: 900 Provident Dr, Warsaw, IN 46580-3252
Phone: (574) 371-2779
Mailing address: 2069 E Wade Rd, Warsaw, IN 46580-7697

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 06004508A (IN)

Other Physical Therapy Assistant providers in Indiana →

Registry record

NPI: 1346660370
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Apr 2014
Record last updated: 24 Apr 2014

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.