Provider Demographics
NPI:1831756394
Name:SHULER, MICHELLE LYNN (MPT)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LYNN
Last Name:SHULER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:BALLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:3834 N RUSSELL RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47408-9642
Mailing Address - Country:US
Mailing Address - Phone:808-782-1326
Mailing Address - Fax:
Practice Address - Street 1:2901 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47404-2065
Practice Address - Country:US
Practice Address - Phone:812-336-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-21
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05013324A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist