Provider Demographics
NPI:1487192068
Name:SHUKLA, JUHI (PT, MHS)
Entity Type:Individual
Prefix:
First Name:JUHI
Middle Name:
Last Name:SHUKLA
Suffix:
Gender:F
Credentials:PT, MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 VOGEL RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-7832
Mailing Address - Country:US
Mailing Address - Phone:812-477-5000
Mailing Address - Fax:812-477-5002
Practice Address - Street 1:5401 VOGEL RD
Practice Address - Street 2:SUITE 140
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-7832
Practice Address - Country:US
Practice Address - Phone:812-477-5000
Practice Address - Fax:812-477-5002
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05012343A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist