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1760937510
KELLY SHANNON
CORVALLIS, OR
NPI
1760937510
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
152W00000X Optometrist
(Licence: OR 4059AT)
Enumeration Date
2016-08-22
Last Update Date
2016-08-22
Business Address
Dr. KELLY SHANNON O.D.
1597 SW 53RD ST
CORVALLIS, OR 97333-2630
Phone number: 541-757-8844
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Mailing Address
Dr. KELLY SHANNON O.D.
1597 SW 53RD ST
CORVALLIS, OR 97333-2630
Phone number: 541-757-8844
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