Individual
SHELBY LINNEA CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11075 W CENTER STREET EXT, MEDINA, NY 14103-9557
(585) 798-1053
Mailing address
2862 ROUTE 62, KENNEDY, NY 14747-9518
(716) 969-7751
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
009096-1
NY
Other
Enumeration date
11/30/2018
Last updated
11/30/2018
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