Shackelford, Marsha

Shackelford, Marsha is an individual health care provider with primary practice located at 100 A Lindsey Lane , Kingsland GA 31548. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Shackelford, Marsha can be contacted via phone (912) 729-1333.

Contact Information

Primary practice address
100 A Lindsey Lane Kingsland GA 31548
Phone: (912) 729-1333
Fax: (912) 729-5259
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT009567 Georgia

Profile Details

NPI number 1417197849
LBN Legal business name Shackelford, Marsha
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 25th, 2009
Last updated May 14th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417197849 NPPES
Georgia MEDICAID 523966767A,B,C,D

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