Provider Demographics
NPI:1699756601
Name:SHELDON ALLS, JOI DARYLENE (PT)
Entity type:Individual
Prefix:MRS
First Name:JOI
Middle Name:DARYLENE
Last Name:SHELDON ALLS
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 1:225 S 12TH ST
Mailing Address - Street 2:
Mailing Address - City:JUNCTION
Mailing Address - State:TX
Mailing Address - Zip Code:76849-5201
Mailing Address - Country:US
Mailing Address - Phone:325-215-4678
Mailing Address - Fax:325-446-8175
Practice Address - Street 1:225 S 12TH ST
Practice Address - Street 2:
Practice Address - City:JUNCTION
Practice Address - State:TX
Practice Address - Zip Code:76849-5201
Practice Address - Country:US
Practice Address - Phone:325-215-4678
Practice Address - Fax:325-446-8175
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1154750225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T4689OtherBLUE CROSS/BLUE SHIELD
TX8T4689OtherBLUE CROSS/BLUE SHIELD