Provider Demographics
NPI:1295564714
Name:SHOTTS THERAPY LLC
Entity type:Organization
Organization Name:SHOTTS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHOTTS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:662-643-5681
Mailing Address - Street 1:17 COUNTY ROAD 535
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-8112
Mailing Address - Country:US
Mailing Address - Phone:662-643-5681
Mailing Address - Fax:
Practice Address - Street 1:17 COUNTY ROAD 535
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-8112
Practice Address - Country:US
Practice Address - Phone:662-643-5681
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-01
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty