MRS. Kelli Deanne Shaw, P.T.A.

NPI #1104059732 in Antlers, Oklahoma

Provider Information

NPI Number: 1104059732
Entity Type: Individual
Name: MRS. Kelli Deanne Shaw, P.T.A.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: P.T.A.
Enumeration Date: Aug 31, 2009
Last Updated: Aug 31, 2009

Practice Location

Address: 402 W MAIN ST
City: Antlers
State: Oklahoma
ZIP Code: 74523-2087
Phone: (580) 298-9818

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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