| NPI | 1164003166 |
|---|---|
| Former Name | SHANNON MILLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P20359) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2021-04-20 |
| Last Update Date | 2025-02-07 |