Provider Demographics
NPI:1033628631
Name:SHEA, WHITNEY (PTA)
Entity type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:
Last Name:SHEA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:LEIGH
Other - Last Name:GRAFA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:3020 CARBON PLACE, #330
Mailing Address - Street 2:PHYSICAL THERAPY OF BOULDER
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301
Mailing Address - Country:US
Mailing Address - Phone:303-938-1141
Mailing Address - Fax:303-938-1311
Practice Address - Street 1:3020 CARBON PLACE, #330
Practice Address - Street 2:PHYSICAL THERAPY OF BOULDER
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301
Practice Address - Country:US
Practice Address - Phone:303-938-1141
Practice Address - Fax:303-938-1311
Is Sole Proprietor?:No
Enumeration Date:2017-09-26
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant