Provider Demographics
NPI:1932653326
Name:WITHIAM, SHELBY (DPT)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:WITHIAM
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 CANAL LANDING BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:GREECE
Mailing Address - State:NY
Mailing Address - Zip Code:14626-5108
Mailing Address - Country:US
Mailing Address - Phone:585-910-2292
Mailing Address - Fax:
Practice Address - Street 1:103 CANAL LANDING BLVD STE 6
Practice Address - Street 2:
Practice Address - City:GREECE
Practice Address - State:NY
Practice Address - Zip Code:14626-5108
Practice Address - Country:US
Practice Address - Phone:585-910-2292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist