Provider Demographics
NPI:1922614908
Name:RATHMELL, SHYLA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SHYLA
Middle Name:
Last Name:RATHMELL
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 1:30530 STATE HIGHWAY 10
Mailing Address - Street 2:
Mailing Address - City:WALTON
Mailing Address - State:NY
Mailing Address - Zip Code:13856-2171
Mailing Address - Country:US
Mailing Address - Phone:607-376-1354
Mailing Address - Fax:
Practice Address - Street 1:1104 ARBOR HILL RD
Practice Address - Street 2:
Practice Address - City:DELHI
Practice Address - State:NY
Practice Address - Zip Code:13753-2208
Practice Address - Country:US
Practice Address - Phone:607-746-4240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046178225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist