Individual
BHUPENDRA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1001 PINEVIEW CIR SW, LIVE OAK, FL 32064-3922
(580) 504-3391
Mailing address
1001 PINEVIEW CIR SW, LIVE OAK, FL 32064-3922
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 31275
FL
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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