Individual
SHELBY MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8 S COMMONS RD, WATERBURY, CT 06704-1035
(203) 759-1229
Mailing address
2938 S 9TH PL, KANSAS CITY, KS 66103-2542
(913) 375-0053
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
11-07243
KS
225100000X
Physical Therapist
Primary
14351
CT
Other
Enumeration date
03/13/2024
Last updated
03/14/2024
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