Individual
MISHA M SHADDIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
7088 UNIVERSITY CT, MONTGOMERY, AL 36117-6992
(334) 396-1400
(334) 396-2727
Mailing address
7088 UNIVERSITY CT, MONTGOMERY, AL 36117-6992
(334) 396-1400
(334) 396-2727
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH 4337
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00172017
RAILROAD MEDICARE #
AL
Enumeration date
08/08/2006
Last updated
07/08/2007
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