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Individual
SHANNON MICHELE DIPPOLD
Active
Individual
SHANNON MICHELE DIPPOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
40QA01243700
NJ
225100000X
Physical Therapist
PT872592
DC
2251P0200X
Pediatric Physical Therapist
032014
NY
2251P0200X
Pediatric Physical Therapist
Primary
PT872592
DC
Other
Enumeration date
11/10/2009
Last updated
08/24/2022
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