Provider Demographics
NPI:1639501059
Name:JOYCE, SHANDLI BLAINE (PT, DPT, ATC, LMT)
Entity type:Individual
Prefix:
First Name:SHANDLI
Middle Name:BLAINE
Last Name:JOYCE
Suffix:
Gender:
Credentials:PT, DPT, ATC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4711 VANN RD
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-7447
Mailing Address - Country:US
Mailing Address - Phone:812-760-1344
Mailing Address - Fax:
Practice Address - Street 1:4711 VANN RD
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-7447
Practice Address - Country:US
Practice Address - Phone:812-760-1344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INMT21103924225700000X
IN05011220A225100000X
IN36001922A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer