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Individual
DORIAN KIM SHANN
Active
Individual
DORIAN KIM SHANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, CSCS
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
044210
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
044210
STATE LICENSE
NY
Enumeration date
03/19/2019
Last updated
11/27/2023
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