Provider Demographics
NPI:1275103434
Name:RHUDY, SHELLEY PINER (MPT)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:PINER
Last Name:RHUDY
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MRS
Other - First Name:SHELLEY
Other - Middle Name:KEATON
Other - Last Name:PINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:2310 SPRUNT AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3116
Mailing Address - Country:US
Mailing Address - Phone:919-672-6543
Mailing Address - Fax:
Practice Address - Street 1:2310 SPRUNT AVE
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3116
Practice Address - Country:US
Practice Address - Phone:919-672-6543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8748225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist