Provider Demographics
NPI:1619768256
Name:SOWDEN, SHELBY (PTA)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:SOWDEN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 N ELLINGTON PKWY STE 6
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:TN
Mailing Address - Zip Code:37091-2454
Mailing Address - Country:US
Mailing Address - Phone:931-982-5702
Mailing Address - Fax:
Practice Address - Street 1:712 N ELLINGTON PKWY STE 6
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:TN
Practice Address - Zip Code:37091-2454
Practice Address - Country:US
Practice Address - Phone:931-982-5702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7966225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant