Marissa Shupperd, DPT

NPI #1245901354 in Eagle, Idaho

Provider Information

NPI Number: 1245901354
Entity Type: Individual
Name: Marissa Shupperd, DPT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Credential: DPT
Enumeration Date: Sep 28, 2021
Last Updated: Jan 26, 2024

Practice Location

Address: 775 S RIVERSHORE LN STE 220
City: Eagle
State: Idaho
ZIP Code: 83616-5783
Phone: (208) 435-8662

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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