Provider Demographics
NPI:1114037934
Name:ALLEN, SHARI (PT, MSPT)
Entity Type:Individual
Prefix:MS
First Name:SHARI
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PT, MSPT
Other - Prefix:MRS
Other - First Name:SHARI
Other - Middle Name:ALLEN
Other - Last Name:NEIBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:7310 N 16TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-5258
Mailing Address - Country:US
Mailing Address - Phone:602-535-8255
Mailing Address - Fax:602-535-8254
Practice Address - Street 1:7310 N 16TH ST STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-5258
Practice Address - Country:US
Practice Address - Phone:602-535-8255
Practice Address - Fax:602-535-8254
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2251X0800X
AZ5591225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ79439Medicare ID - Type Unspecified