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1437444163
EVERETT LEE SHAW
DECATUR, IL
NPI
1437444163
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IL 085.004037)
Enumeration Date
2011-06-10
Last Update Date
2023-01-17
Business Address
EVERETT LEE SHAW PA-C
4775 E MARYLAND ST
DECATUR, IL 62521-8820
Phone number: 217-864-3737
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Mailing Address
EVERETT LEE SHAW PA-C
517 N MAIN ST
ANNA, IL 62906-1668
Phone number: 618-833-4300
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