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1295781243
JAMIE SHANNON SOUTAR
NEWARK, DE
NPI
1295781243
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: DE J2-0000488)
Enumeration Date
2006-05-25
Last Update Date
2007-07-08
Business Address
Mr. JAMIE SHANNON SOUTAR PTA
130 EXECUTIVE DR
NEWARK, DE 19702-3349
Phone number: 302-292-3454
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Mailing Address
Mr. JAMIE SHANNON SOUTAR PTA
203 TINSLEY CT
NEWARK, DE 19702-2819
Phone number: 302-266-7122
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