MEDICARE: SHANNON PERRY DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	013593	OH

General Provider Information

NPI Number	:	1568877017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON PERRY DPT

Provider Business Mailing Address
First Line	:	12300 MCCRACKEN RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44125-2914
Country	:	US
Telephone Number	:	216-587-8108
Fax Number	:

Provider Business Practice Location Address
First Line	:	12300 MCCRACKEN RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44125-2914
Country	:	US
Telephone Number	:	216-587-8108
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2014
Last Update Date	:	03/31/2020

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Directions to “ SHANNON PERRY DPT” Practice Location

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