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Individual
SHELLY MARIE ALLIS
Active
Individual
SHELLY MARIE ALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 14733
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
183834100
US DEPT OF LABOR
—
01
—
OPT147330
BLUE SHIELD PIN
CA
01
—
PT147330
BLUE CROSS PIN
CA
05
—
PT147330
—
CA
Enumeration date
11/22/2006
Last updated
05/31/2016
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