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1003987025
SHANNON LEE WHEELOCK
WATERTOWN, NY
NPI
1003987025
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 274044)
Enumeration Date
2006-11-13
Last Update Date
2007-07-08
Business Address
-- SHANNON LEE WHEELOCK
20800 CARR RD
WATERTOWN, NY 13601-5244
Phone number: 315-405-8469
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Mailing Address
-- SHANNON LEE WHEELOCK
20800 CARR RD
WATERTOWN, NY 13601-5244
Phone number:
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