Organization
SHIFT PHYSICAL THERAPY & PERFORMANCE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA DILLON (CEO)
(989) 860-8494
Entity
Organization
Contact information
Practice address
308 W LINE ST STE B, BISHOP, CA 93514-3452
(760) 914-4401
Mailing address
308 W LINE ST STE B, BISHOP, CA 93514-3452
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699007658
—
CO
05
—
1801386651
—
CA
Enumeration date
06/11/2022
Last updated
06/11/2022
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