Provider Demographics
NPI:1386933380
Name:YORKE, SHANNON D (PTA)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:D
Last Name:YORKE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 DEPOT ST
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:MA
Mailing Address - Zip Code:01225-8913
Mailing Address - Country:US
Mailing Address - Phone:413-743-2976
Mailing Address - Fax:
Practice Address - Street 1:1 BERKSHIRE SQ
Practice Address - Street 2:
Practice Address - City:ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01220-1300
Practice Address - Country:US
Practice Address - Phone:413-446-7537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7769225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant