Provider Demographics
NPI:1699051284
Name:DELANEY-SHOFFMAN, ERIN K (PT)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:K
Last Name:DELANEY-SHOFFMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 1ST CAPITOL DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-2881
Mailing Address - Country:US
Mailing Address - Phone:636-947-5467
Mailing Address - Fax:636-947-7084
Practice Address - Street 1:400 1ST CAPITOL DR STE 101
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2881
Practice Address - Country:US
Practice Address - Phone:636-947-5467
Practice Address - Fax:636-947-7084
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-26
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO200202012225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist