Provider Demographics
NPI:1629475439
Name:SHAMBLIN, ERIN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:SHAMBLIN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WYNDHAM KNOB
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26104-9497
Mailing Address - Country:US
Mailing Address - Phone:304-552-9514
Mailing Address - Fax:
Practice Address - Street 1:400 N 7TH ST
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-2024
Practice Address - Country:US
Practice Address - Phone:740-373-3597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-21
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV003406225100000X
OH015166225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist