Provider Demographics
NPI:1710473905
Name:SWEET, SHELBY NICHOL (PT)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:NICHOL
Last Name:SWEET
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 1:700 LEONARD ST
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16830-3245
Mailing Address - Country:US
Mailing Address - Phone:814-765-7545
Mailing Address - Fax:
Practice Address - Street 1:700 LEONARD ST
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830-3245
Practice Address - Country:US
Practice Address - Phone:814-765-7545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-10
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013711L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist