Provider Demographics
NPI:1972847267
Name:SHEPHERD, TORRIE CHRISTINA DIANE (PT)
Entity Type:Individual
Prefix:MRS
First Name:TORRIE
Middle Name:CHRISTINA DIANE
Last Name:SHEPHERD
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 1:123 W LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:45814-9675
Mailing Address - Country:US
Mailing Address - Phone:419-365-4040
Mailing Address - Fax:
Practice Address - Street 1:123 W LIBERTY ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:OH
Practice Address - Zip Code:45814-9675
Practice Address - Country:US
Practice Address - Phone:419-365-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.012865225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist