Individual provider · Type 1 NPI

Shannon Raye Roderique, LPTA

Physical Therapy Assistant · O Fallon, MO

NPI number 1992405302 Active

Practice location

7068 S Outer 364
O Fallon, MO 63368-7757

Call (636) 240-6100 Map

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000XNone listed

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1992405302

Shannon Raye Roderique, LPTA's National Provider Identifier is 1992405302, issued on Mar 6, 2023. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in O Fallon, MO. The record was last updated on Mar 6, 2023.