Provider Demographics
NPI:1861824286
Name:SHEPHERD, CALEY JEAN (DPT)
Entity type:Individual
Prefix:DR
First Name:CALEY
Middle Name:JEAN
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 MORRILL RD
Mailing Address - Street 2:
Mailing Address - City:CANTERBURY
Mailing Address - State:NH
Mailing Address - Zip Code:03224-2308
Mailing Address - Country:US
Mailing Address - Phone:603-273-5113
Mailing Address - Fax:603-451-1489
Practice Address - Street 1:261 MORRILL RD
Practice Address - Street 2:
Practice Address - City:CANTERBURY
Practice Address - State:NH
Practice Address - Zip Code:03224-2308
Practice Address - Country:US
Practice Address - Phone:603-496-1831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2630225100000X
CT009703225100000X
NH3768225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist