Provider Demographics
NPI:1275790024
Name:SHEPLEY, AMY JOY (PT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:JOY
Last Name:SHEPLEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 TAMARACK CIR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22602-6749
Mailing Address - Country:US
Mailing Address - Phone:540-550-5269
Mailing Address - Fax:540-667-7621
Practice Address - Street 1:409 TAMARACK CIR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602-6749
Practice Address - Country:US
Practice Address - Phone:540-550-5269
Practice Address - Fax:540-667-7621
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305003060225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist