Organization
SHAPE SHIFTERS WELLNESS STUDIO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN DRISCOLL P.T. (PHYSICAL THERAPIST/OWNER)
(443) 386-0818
Entity
Organization
Contact information
Practice address
169 FREDERICK RD, ELLICOTT CITY, MD 21043-4886
(443) 386-0818
(410) 465-5522
Mailing address
3614 OLD MANSE CT, ELLICOTT CITY, MD 21043-4144
(443) 386-0818
(410) 465-5522
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
16510
MD
Other
Enumeration date
04/23/2015
Last updated
04/23/2015
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