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Individual
SHANNON TARA BARLOW
Active
Individual
SHANNON TARA BARLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
2081P0010X
Pediatric Rehabilitation Medicine Physician
Primary
PT-1900
ID
261QP2000X
Physical Therapy Clinic/Center
PT-1900
ID
Other
Enumeration date
06/28/2022
Last updated
10/01/2024
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