Individual
SHANDLI BLAINE JOYCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, ATC, LMT
Contact information
Practice address
4711 VANN RD, NEWBURGH, IN 47630-7447
(812) 760-1344
Mailing address
4711 VANN RD, NEWBURGH, IN 47630-7447
(812) 760-1344
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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