Tiara D Shipe, PT | |
845 Water Street, Northumberland, PA 17857-0064 | |
(570) 473-3912 | |
(570) 473-8731 |
Full Name | Tiara D Shipe |
---|---|
Gender | Female |
Speciality | Physical Medicine & Rehabilitation |
Location | 845 Water Street, Northumberland, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1457588113 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208100000X | Physical Medicine & Rehabilitation | PT019919 (Pennsylvania) | Primary |
Entity Name | Shipe Physical Therapy Llc |
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Entity Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Entity Identifiers | NPI Number: 1760158562 PECOS PAC ID: 7012308406 Enrollment ID: O20211220000039 |
Mailing Address | Practice Location Address |
---|---|
Tiara D Shipe, PT Po Box 64, 845 Water Street, Northumberland, PA 17857-0064 Ph: (570) 473-3912 | Tiara D Shipe, PT 845 Water Street, Northumberland, PA 17857-0064 Ph: (570) 473-3912 |
Kimberly Petusky, PTA Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 58 Neitz Rd, Northumberland, PA 17857 Phone: 570-473-8366 | |
Susan Elaine Webster, PT Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 845 Water St, Northumberland, PA 17857 Phone: 570-473-3912 Fax: 570-473-8731 |