Individual
KYLE P SHAFFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4725 S COLONIAL OAKS DR, MARION, IN 46953-5341
(765) 674-9791
Mailing address
1311 MAMARONECK AVE STE 140, WHITE PLAINS, NY 10605-5224
(914) 249-5050
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05010977A
IN
225100000X
Physical Therapist
99053331A
IN
Other
Enumeration date
08/21/2012
Last updated
05/04/2023
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