| NPI | 1154592327 |
|---|---|
| Former Name | SHANNON L FREY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 1126) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SD 1099) |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2008-03-17 |