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Individual

MRS. CARRIE SHORTRIDGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA, ATC

Contact information

Practice address
514 STATE ROAD 32 E, WESTFIELD, IN 46074-8767
(877) 366-2663
(317) 867-7701
Mailing address
PO BOX 358, TIPTON, IN 46072-0358
(765) 675-8119
(765) 675-8257

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06001754A
IN
2255A2300X
Athletic Trainer
36000474A
IN

Other

Enumeration date
09/08/2008
Last updated
12/07/2011
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