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Individual
MRS. SHANNA L TREADWELL
Active
Individual
MRS. SHANNA L TREADWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
033404
NY
225100000X
Physical Therapist
P78218
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03296820
—
NY
Enumeration date
11/23/2010
Last updated
12/08/2011
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