Provider Demographics
NPI:1457522146
Name:SHUEY PHYSICAL THERAPY
Entity Type:Organization
Organization Name:SHUEY PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:SHUEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:864-261-4322
Mailing Address - Street 1:1650 E GREENVILLE ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-2086
Mailing Address - Country:US
Mailing Address - Phone:864-261-4322
Mailing Address - Fax:864-261-4323
Practice Address - Street 1:1650 E GREENVILLE ST
Practice Address - Street 2:SUITE F
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-2086
Practice Address - Country:US
Practice Address - Phone:864-261-4322
Practice Address - Fax:864-261-4323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1133174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ33444Medicare UPIN
SC7794Medicare PIN