Provider Demographics
NPI:1932653326
Name:WITHIAM, SHELBY (DPT)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:WITHIAM
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1 CREDIT UNION WAY
Mailing Address - Street 2:FL3
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4633
Mailing Address - Country:US
Mailing Address - Phone:781-961-3370
Mailing Address - Fax:781-961-1291
Practice Address - Street 1:141 LONGWATER DR STE 109
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1620
Practice Address - Country:US
Practice Address - Phone:339-788-9202
Practice Address - Fax:339-788-9872
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist