Provider Demographics
NPI:1710365507
Name:STALLINGS, SHELLEY D (DPT)
Entity Type:Individual
Prefix:MS
First Name:SHELLEY
Middle Name:D
Last Name:STALLINGS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 FARM LIFE AVE
Mailing Address - Street 2:
Mailing Address - City:VANCEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28586-7669
Mailing Address - Country:US
Mailing Address - Phone:252-635-7435
Mailing Address - Fax:
Practice Address - Street 1:271 FARM LIFE AVE
Practice Address - Street 2:
Practice Address - City:VANCEBORO
Practice Address - State:NC
Practice Address - Zip Code:28586-7669
Practice Address - Country:US
Practice Address - Phone:252-635-7435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-12
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP15631225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist