Individual
SHANNON HARTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
29 L V STABLER DR, GREENVILLE, AL 36037-3850
(334) 383-2256
(334) 383-2341
Mailing address
29 L V STABLER DR, GREENVILLE, AL 36037-3850
(334) 383-2256
(334) 383-2341
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
23263
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51502576
BCBS AL PROVIDOR #
AL
Enumeration date
04/25/2007
Last updated
07/08/2007
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