Healthcare Provider Details

I. General information

NPI: 1134464431
Provider Name (Legal Business Name): SHANNON ARNIE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2012
Last Update Date: 11/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 MILFORD ST STE 601
SALISBURY MD
21804-6938
US

IV. Provider business mailing address

106 MILFORD ST STE 601
SALISBURY MD
21804-6938
US

V. Phone/Fax

Practice location:
  • Phone: 410-548-7600
  • Fax: 410-548-2651
Mailing address:
  • Phone: 410-548-7600
  • Fax: 410-548-2651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number24254
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: