Provider Demographics
NPI:1184890279
Name:CAREY, SHAWN WILLIAM (PT)
Entity type:Individual
Prefix:MR
First Name:SHAWN
Middle Name:WILLIAM
Last Name:CAREY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5510 ROBINRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2731
Mailing Address - Country:US
Mailing Address - Phone:336-404-0611
Mailing Address - Fax:
Practice Address - Street 1:1031 E MOUNTAIN ST
Practice Address - Street 2:BLDG 318, STE 101
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-7997
Practice Address - Country:US
Practice Address - Phone:336-996-4980
Practice Address - Fax:336-996-3521
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2697225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist