Individual
MR. GARY JOHN SHUTTLEWORTH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
1070 OLD NATIONAL PIKE, FREDERICKTOWN, PA 15333-2114
(724) 632-6801
Mailing address
1070 OLD NATIONAL PIKE, FREDERICKTOWN, PA 15333-2114
(724) 632-6801
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT009691L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1676875
—
PA
Enumeration date
11/02/2005
Last updated
07/08/2007
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