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1215283825
SHANNON MARIE LANE
PROVIDENCE, RI
NPI
1215283825
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: RI PTA 00880)
Enumeration Date
2012-08-01
Last Update Date
2012-08-01
Business Address
-- SHANNON MARIE LANE
195 COLLYER ST
PROVIDENCE, RI 02904-1869
Phone number: 401-793-4080
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Mailing Address
-- SHANNON MARIE LANE
195 COLLYER ST
PROVIDENCE, RI 02904-1869
Phone number: 401-793-4080
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