Provider Demographics
NPI:1730829706
Name:BLANKENSHIP, SHELBY LEIGH (PT,DPT)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:LEIGH
Last Name:BLANKENSHIP
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190D SAUNDERSVILLE RD STE 2002
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-1008
Mailing Address - Country:US
Mailing Address - Phone:937-671-7600
Mailing Address - Fax:
Practice Address - Street 1:190D SAUNDERSVILLE RD STE 2002
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-1008
Practice Address - Country:US
Practice Address - Phone:937-671-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11778225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist