| NPI | 1477986636 |
|---|---|
| Former Name | SHANNON LEIGH THOMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305212541) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 006262) |
| 225100000X Physical Therapist (Licence: CA 42228) | |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2024-10-14 |