Provider Demographics
NPI:1649928987
Name:SHIPLEY, BRIANNE ALYCE (PT)
Entity type:Individual
Prefix:
First Name:BRIANNE
Middle Name:ALYCE
Last Name:SHIPLEY
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 1:1792 NOSS RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17408-8990
Mailing Address - Country:US
Mailing Address - Phone:717-515-7880
Mailing Address - Fax:
Practice Address - Street 1:1792 NOSS RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17408-8990
Practice Address - Country:US
Practice Address - Phone:717-515-7880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017625225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist