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NPI Code Detail

MEDICARE: DAVID SHANNON

MEDICARE: DAVID SHANNON
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 Assistant

General Provider Information

NPI Number : 1831481787
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID SHANNON
Provider Business Mailing Address
First Line : 1808 MILLER DR
Second Line :
City : LAWRENCE
State : KS
Zip : 66044-4352
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2428 BAHAMA DR
Second Line :
City : DALLAS
State : TX
Zip : 75211-2121
Country : US
Telephone Number : 214-948-3811
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2011
Last Update Date : 05/11/2011

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Directions to “ DAVID SHANNON ” Practice Location

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