Individual
DIVYA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1320 S GREEN BAY RD, MOUNT PLEASANT, WI 53406-4402
(262) 886-3431
Mailing address
9107 PARKSIDE AVE, MORTON GROVE, IL 60053-2553
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
06/25/2019
Last updated
06/25/2019
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