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Individual
MS. SHELLEY A. MAZZIE
Active
Individual
MS. SHELLEY A. MAZZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
001799
WV
225100000X
Physical Therapist
Primary
12370
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0158210-001
—
WV
01
—
650023877
RAILROAD MEDICARE
WV
Enumeration date
06/27/2005
Last updated
09/26/2011
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