Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHANE DAVIS, P.T.
Active Sole ProprietorPhysical Therapy Assistant · BOONVILLE, NY
Registration Details
- NPI Number
- 1033170725
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 31, 2006 (20.120343931805 yrs)
- Last Updated
- Jun 27, 2025
- License
-
022935 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
13040 STATE ROUTE 12BOONVILLE, NY, 133094942Browse NY providers · Browse ZIP 13309
- Phone
- 3153584028
- Fax
- 3153584394
- Primary Specialty
-
Physical Therapy Assistant
225100000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.