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General NPI Number Information
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NPI Number | 1477986636
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Entity Type | Individual
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Provider Name | SHANNON LEIGH THOMPSON NEWMAN P.T., D.P.T., COMT
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Gender | Female
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Dates
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Enumeration Date | 08/12/2013
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 680 KINGSBOROUGH SQ STE B
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City | CHESAPEAKE
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State | VA
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Zip | 23320
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Country | US
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Telephone | 757-547-0434
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Fax | 757-437-2716
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Provider Business Mailing Address
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Address Line | 790 REMINGTON BLVD
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City | BOLINGBROOK
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State | IL
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Zip | 60440-4909
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Country | US
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Telephone |
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 006262
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 42228
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305212541
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License Number State | VA
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