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Organization
SHANNON LOGAN HEALY PT
Active
Organization
SHANNON LOGAN HEALY PT
Active
Other names
Shannon Logan Healy
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SHANNON LOGAN HEALY MPT (PHYSICAL THERAPIST/OWNER)
(310) 650-3854
Entity
Organization
Contact information
Practice address
1033 12TH STREET, 102, SANTA MONICA, CA 90403
(310) 650-3854
Mailing address
1033 12TH STREET, 102, SANTA MONICA, CA 90403
(310) 650-3854
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
35550
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT35550
CA LICENSE
CA
Enumeration date
12/15/2010
Last updated
12/15/2010
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