Basic Information
| Provider Information | |||||||||
| NPI: | 1427255405 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LOBIANCO | ||||||||
| FirstName: | SHELLA | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | M.S.,P.T. | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | JOHNSTON | ||||||||
| OtherFirstName: | SHELLA | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 77 S ELLIOTT RD | ||||||||
| Address2: | |||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275145827 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199327266 | ||||||||
| FaxNumber: | 9199327250 | ||||||||
| Practice Location | |||||||||
| Address1: | 77 S ELLIOTT RD | ||||||||
| Address2: | |||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275145827 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199327266 | ||||||||
| FaxNumber: | 9199327250 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2007 | ||||||||
| LastUpdateDate: | 05/13/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 14164 | NC | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | PT 23052 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.