Provider Demographics
NPI:1225284102
Name:SHELTON, MASON M (PT)
Entity Type:Individual
Prefix:DR
First Name:MASON
Middle Name:M
Last Name:SHELTON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5133 BOYLSTON HWY
Mailing Address - Street 2:
Mailing Address - City:MILLS RIVER
Mailing Address - State:NC
Mailing Address - Zip Code:28759-5737
Mailing Address - Country:US
Mailing Address - Phone:828-891-0085
Mailing Address - Fax:828-890-4423
Practice Address - Street 1:5133 BOYLSTON HWY
Practice Address - Street 2:
Practice Address - City:MILLS RIVER
Practice Address - State:NC
Practice Address - Zip Code:28759-5737
Practice Address - Country:US
Practice Address - Phone:828-891-0085
Practice Address - Fax:828-890-4423
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11675225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist