SHANE KENNETH MCCORMICK

JACKSON, WY
NPI1295071611
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225X00000X Occupational Therapist
(Licence: WY  OT-1386)
Enumeration Date2012-12-13
Last Update Date2020-07-01
Business Address
Mr. SHANE KENNETH MCCORMICK OTR/L
310 E BROADWAY AVE
JACKSON, WY 83001-8636
Phone number: 307-734-2877
Mailing Address
Mr. SHANE KENNETH MCCORMICK OTR/L
555 SAINT JOSEPHS BLVD
ELMIRA, NY 14901-3223
Phone number: 607-733-6541