| NPI | 1861970568 |
|---|---|
| Former Name | SHANNON TOMASELLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT033734) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 27140) |
| Enumeration Date | 2018-08-03 |
| Last Update Date | 2025-09-17 |