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Individual

MS. THERESA LYNN SHAFFER-WETHINGTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
2117 40TH AVE, GREELEY, CO 80634-3901
(970) 302-3980
Mailing address
2117 40TH AVE, GREELEY, CO 80634-3901
(970) 302-3980

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
0023819
CO
225X00000X
Occupational Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
69107084
CO
Enumeration date
01/22/2007
Last updated
11/20/2020
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