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NPI Code Detail

MEDICARE: MRS. SHANNON MARIE POTTER-KNIGHT LPTA

MEDICARE: MRS. SHANNON MARIE POTTER-KNIGHT LPTA
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
1225200000XPhysical Therapy Assistant06131OH

General Provider Information

NPI Number : 1538284856
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHANNON MARIE POTTER-KNIGHT LPTA
Provider Business Mailing Address
First Line : 5980 MARINE PKWY
Second Line : APT B-110
City : MENTOR ON THE LAKE
State : OH
Zip : 44060-8518
Country : US
Telephone Number : 440-257-7569
Fax Number :
Provider Business Practice Location Address
First Line : 3 MERIT DR
Second Line :
City : RICHMOND HEIGHTS
State : OH
Zip : 44143-1457
Country : US
Telephone Number : 216-261-9600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 07/08/2007

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