IndividualActive
Shane Famille, PT, ATC
NPI 1689781593 · Sports Physical Therapist · Glendora, NJ
Provider details
- NPI number
- 1689781593
- Entity type
- Individual
- Primary specialty
- Sports Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PT, ATC
- Sex
- Male
- Sole proprietor
- No
- License
- 25MT00125600 (NJ)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
17 11th Ave
Glendora, NJ 08029-1333
Phone: (856) 216-0047
Fax: (856) 427-9314
Approximate (ZIP-level) locationGet directions
Mailing address
17 11th Ave
Glendora, NJ 08029-1333
Registry dates
- Enumerated
- 2006-08-24
- Last updated
- 2010-02-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.