Tiffany Rachelle Shull, PTA

NPI #1144701749 in Arcola, Illinois

Provider Information

NPI Number: 1144701749
Entity Type: Individual
Name: Tiffany Rachelle Shull, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Aug 22, 2018
Last Updated: Aug 22, 2018

Practice Location

Address: 909 GREEN MILL RD
City: Arcola
State: Illinois
ZIP Code: 61910-3527
Phone: (217) 268-3516

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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