Provider Demographics
NPI:1700988110
Name:SHUTTLEWORTH, WILLIAM JOSEPH (MSPT)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:SHUTTLEWORTH
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:JOSEPH
Other - Last Name:SANTAMARIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:710 N LEMON AVE UNIT 304
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-4289
Mailing Address - Country:US
Mailing Address - Phone:419-923-9999
Mailing Address - Fax:
Practice Address - Street 1:8588 POTTER PARK DR STE 201
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-5471
Practice Address - Country:US
Practice Address - Phone:941-361-9020
Practice Address - Fax:941-217-4038
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016373225100000X
FLPT26778225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist