Shane Wallen

NPI #1346660370 in Warsaw, Indiana

Provider Information

NPI Number: 1346660370
Entity Type: Individual
Name: Shane Wallen
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Apr 17, 2014
Last Updated: Apr 24, 2014

Practice Location

Address: 900 PROVIDENT DR
City: Warsaw
State: Indiana
ZIP Code: 46580-3252
Phone: (574) 371-2779

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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