| NPI | 1891092722 |
|---|---|
| Former Name | SHANNA A PAINTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT6112) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AR PT3331) |
| 225100000X Physical Therapist (Licence: AL PTH6346) | |
| Enumeration Date | 2011-02-11 |
| Last Update Date | 2021-03-09 |