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Individual

JASON MICHAEL SHIPLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
8322 BELLONA AVE, TOWSON, MD 21204-2012
(410) 337-8847
(410) 769-8591
Mailing address
8322 BELLONA AVE, TOWSON, MD 21204-2012
(410) 337-8847
(410) 769-8591

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
21920
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
21920
PHYSICAL THERAPIST LICENS
MD
Enumeration date
08/18/2006
Last updated
11/13/2013
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