Provider Demographics
NPI:1578126603
Name:WEBER, SHEILA LANE (PT)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:LANE
Last Name:WEBER
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 1:2116 E ORANGEBURG AVE STE B
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-3370
Mailing Address - Country:US
Mailing Address - Phone:209-602-5345
Mailing Address - Fax:209-572-2841
Practice Address - Street 1:2116 E ORANGEBURG AVE STE B
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-3370
Practice Address - Country:US
Practice Address - Phone:209-602-5345
Practice Address - Fax:209-572-2841
Is Sole Proprietor?:No
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist