Individual
NICOLE RAE SHOUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
10088
CO
225100000X
Physical Therapist
Primary
1810
SD
225100000X
Physical Therapist
2012030396
MO
Other
Enumeration date
07/25/2008
Last updated
04/22/2026
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