SHANNON RAE BALTHAZR

BRISTOL, TN
NPI1891869186
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: TN  3766)
Enumeration Date2006-11-20
Last Update Date2007-07-08
Business Address
-- SHANNON RAE BALTHAZR PTA
1 MEDICAL PARK BLVD
BRISTOL, TN 37620-7430
Phone number: 423-844-4104
Mailing Address
-- SHANNON RAE BALTHAZR PTA
285 BLUFF ROAD
BLOUNTVILLE, TN 37617
Phone number: 423-502-1492
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