Provider Demographics
NPI:1528508181
Name:SHOPE, LINDSEY ANN (PTA)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ANN
Last Name:SHOPE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:ANN
Other - Last Name:SHEEDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16678 BEAVERTOWN RD
Mailing Address - Street 2:
Mailing Address - City:CALVIN
Mailing Address - State:PA
Mailing Address - Zip Code:16622-5215
Mailing Address - Country:US
Mailing Address - Phone:814-305-2230
Mailing Address - Fax:
Practice Address - Street 1:4702 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:PA
Practice Address - Zip Code:17004-9251
Practice Address - Country:US
Practice Address - Phone:717-935-2105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE011287225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant