Individual
SHANDLI BLAINE JOYCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, ATC, LMT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05011220A
IN
2255A2300X
Athletic Trainer
36001922A
IN
225700000X
Massage Therapist
MT21103924
IN
Other
Enumeration date
08/08/2013
Last updated
03/01/2025
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