Mr. Shane Famille, PT, ATC
Mr. Shane Famille, PT, ATC is a Physical Therapist in Private Practice in Glendora, New Jersey. Qualified in 2009, 17 years ago. Licensed in New Jersey.
- Years since qualifying
- 17
- Licensed in
- NJ
- In the registry since
- 2006
- Specialties on file
- 2
What do these letters mean?
Practice location Address checks out
17 11th AveGlendora, NJ 08029-1333
Phone: (856) 216-0047
Fax: (856) 427-9314
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Sports Physical Therapist (primary) | Taxonomy 2251S0007X · Licence 40QA01317800 (NJ) |
|---|---|
| Athletic Trainer | Taxonomy 2255A2300X · Licence 25MT00125600 (NJ) |
Record details
| NPI number | 1689781593 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | PT , ATC |
| Sole proprietor | No |
| NPI enumerated | August 24, 2006 |
| Last updated in NPPES | February 1, 2010 |
Medicare enrollment
| Medicare specialty | PHYSICAL THERAPIST IN PRIVATE PRACTICE |
|---|---|
| Medical school | OTHER |
| Graduated | 2009 (17 years in practice) |
| Accepts Medicare assignment | Not indicated |
| Practice locations | 3 on file with Medicare |
Other providers in Glendora
-
Aja Brianna Corchado
104 Bozarth Ave, Glendora, NJ 08029-1241 · (856) 448-0967