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Individual

JUSTIN RYAN SHEPHERD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MPT

Contact information

Practice address
201 OFFICE PARK DR STE 150, MOUNTAIN BRK, AL 35223-2400
(205) 278-2250
(205) 543-2034
Mailing address
800 CRESCENT CENTRE DR STE 600, FRANKLIN, TN 37067-7286
(615) 373-1350
(615) 221-9054

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT6646
TN
225100000X
Physical Therapist
Primary
PTH7280
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3658050
TN
01
4111092
BCBST
TN
05
5441656
TN
Enumeration date
06/02/2006
Last updated
02/09/2024
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