Provider Demographics
NPI:1831209667
Name:SHROPSHIRE, JASON (PT)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:SHROPSHIRE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:456 ARNELL LANE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830
Mailing Address - Country:US
Mailing Address - Phone:334-887-1370
Mailing Address - Fax:
Practice Address - Street 1:121 NORTH 20TH STREET NUMBER 18
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:38803
Practice Address - Country:US
Practice Address - Phone:334-364-2249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH45812251X0800X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPTH4581OtherLICENSE #