Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KEVIN SHADDOCK, DPT
Active Sole ProprietorHand Therapy · PONTE VEDRA, FL
Registration Details
- NPI Number
- 1568940617
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 31, 2018 (7.7270761500518 yrs)
- Last Updated
- Jul 31, 2018
- License
-
PT33637 (FL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
816 A1A N STE 307PONTE VEDRA, FL, 320823219Browse FL providers · Browse ZIP 32082
- Phone
- 4021904543
- Primary Specialty
-
Hand Therapy
2251G0304X
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.