Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist |
NPI | 1003324088 |
---|---|
Provider Name | Shelby Schubert |
First Address | Lansing, MI 48917-8687 |
Second Address | Lansing, MI 48917-8687 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2018 |
Last Update Date | 26/02/2019 |