| 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 |
|---|---|
| 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 |