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Individual
SHANNON L TENNANT
Active
Individual
SHANNON L TENNANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
012394
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000270651
OH MEDICAID UNISON
OH
01
—
1174767677
MED MUTAL OF OHIO
—
01
—
2970129
OH MEDICAID MOLINA
OH
05
—
2970129
—
OH
05
—
3810014932
—
WV
01
—
P00794068
RAILROAD MEDICARE
OH
Enumeration date
04/28/2009
Last updated
02/03/2012
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