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1104389980
SHANNON HALSTEAD
PHOENIX, AZ
NPI
1104389980
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: AZ LPT-008573)
Enumeration Date
2019-04-09
Last Update Date
2019-04-09
Business Address
SHANNON HALSTEAD
4202 N 20TH AVE
PHOENIX, AZ 85015-5101
Phone number: 602-264-3824
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Mailing Address
SHANNON HALSTEAD
3713 N 125TH DR
AVONDALE, AZ 85392-6317
Phone number:
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