Individual
MATTHEW SHIRLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1817 NORTHPOINTE LANE, RUSTON, LA 71270-3879
(318) 255-9601
(318) 255-7591
Mailing address
P.O. BOX 1306, RUSTON, LA 71273-1306
(618) 255-9601
(318) 255-7591
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
04702
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G5096
BCBS
LA
Enumeration date
07/02/2007
Last updated
12/15/2011
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