Individual
MR. JERRY LEE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2000 PEPPERELL PKWY, OPELIKA, AL 36801-5452
(334) 528-3270
Mailing address
1030 GREGORY GLEN RD, OPELIKA, AL 36801-9417
(334) 826-3353
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PTH2028
AL
2255A2300X
Athletic Trainer
Primary
96096
AL
Other
Enumeration date
06/02/2006
Last updated
07/13/2026
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