Individual
MR. SETH T SHAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
903 MOORE DR, FLORENCE, CO 81226-9509
(719) 251-4411
(719) 275-0442
Mailing address
2911 3RD AVE, PUEBLO, CO 81008-1105
(719) 251-4411
(719) 275-0442
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-456
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA-456
PTA LICENSURE
WY
Enumeration date
07/30/2007
Last updated
07/30/2007
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