Provider Demographics
NPI:1053551044
Name:ANDREWS, SHAUNTA (DPT)
Entity type:Individual
Prefix:MISS
First Name:SHAUNTA
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:SHAUNTA
Other - Middle Name:ANDREWS
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2823 GREYSTONE COMMERCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2660
Mailing Address - Country:US
Mailing Address - Phone:205-745-3660
Mailing Address - Fax:205-745-3649
Practice Address - Street 1:6485 UNIVERSITY DR NW STE C
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-1715
Practice Address - Country:US
Practice Address - Phone:256-513-8280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-03
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PTH5473225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist