Provider Demographics
NPI:1912936485
Name:WINTERS, SHANNA M (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:SHANNA
Middle Name:M
Last Name:WINTERS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:SHANNA
Other - Middle Name:MARIE
Other - Last Name:NEFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:100 LODER ST STE 105
Mailing Address - Street 2:
Mailing Address - City:HORNELL
Mailing Address - State:NY
Mailing Address - Zip Code:14843-1957
Mailing Address - Country:US
Mailing Address - Phone:607-324-9344
Mailing Address - Fax:607-324-9345
Practice Address - Street 1:191 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WELLSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14895-1150
Practice Address - Country:US
Practice Address - Phone:585-596-4011
Practice Address - Fax:585-596-4012
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025102-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist