Provider Demographics
NPI:1104903426
Name:SHIFFLER, MATTHEW A (MPT)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:A
Last Name:SHIFFLER
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22664
Mailing Address - Country:US
Mailing Address - Phone:540-459-7660
Mailing Address - Fax:540-459-7670
Practice Address - Street 1:816 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:VA
Practice Address - Zip Code:22664
Practice Address - Country:US
Practice Address - Phone:540-459-7660
Practice Address - Fax:540-459-7670
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPT001777225100000X
VA2305005665225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist