Provider Demographics
NPI:1285445668
Name:FERRELL, SHELBY LYNN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:SHELBY
Middle Name:LYNN
Last Name:FERRELL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30822 HIVELEY ST
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186-5084
Mailing Address - Country:US
Mailing Address - Phone:734-673-7762
Mailing Address - Fax:
Practice Address - Street 1:44560 FORD RD STE B
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2944
Practice Address - Country:US
Practice Address - Phone:734-680-8787
Practice Address - Fax:734-418-0745
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501303538225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist