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General NPI Number Information
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NPI Number | 1194801019
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Entity Type | Individual
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Provider Name | SHANNON A CARRO OTR
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Gender | Female
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 01/15/2015
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Provider Practice Location Address
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Address Line | 340 S BROADWAY ST
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City | WICHITA
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State | KS
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Zip | 67202-4304
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Country | US
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Telephone | 316-267-5437
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Fax | 316-267-5444
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Provider Business Mailing Address
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Address Line | 1655 S GEORGETOWN ST
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City | WICHITA
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State | KS
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Zip | 67218-4140
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Country | US
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Telephone | 316-685-0400
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Fax | 316-612-0839
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225000000X
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Taxonomy Name | Orthotic Fitter
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License Number | T00720
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License Number State | KS
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