Individual
SHANE SHIRLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
25072 NORTHWESTERN PIKE, ROMNEY, WV 26757-5039
(304) 822-2177
Mailing address
PO BOX 288, ROMNEY, WV 26757-0288
(304) 822-2177
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002791
WV
Other
Enumeration date
07/18/2022
Last updated
07/18/2022
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