Individual
MS. ELISE BLAIR SHEVENELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, PT
Contact information
Practice address
15 COURT SQ, SUITE 345, BOSTON, MA 02108-2503
(617) 742-4897
(617) 742-4899
Mailing address
15 COURT SQ, SUITE 345, BOSTON, MA 02108-2503
(617) 742-4897
(617) 742-4899
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3804
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y65801
BLUE CROSS - BLUE SHIELD
MA
Enumeration date
09/02/2006
Last updated
07/08/2007
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