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Individual
SHAUN R OCONNOR
Active
Individual
SHAUN R OCONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0400002899
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06528695
BLUE CROSS
—
01
—
43V010
MVP
—
01
—
5206001
VMC GMI
—
Enumeration date
11/10/2006
Last updated
08/12/2015
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