Individual
SHANNON MCINTOSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9 BALMORAL DR STE A, POPLARVILLE, MS 39470-3344
(601) 746-5101
(601) 746-5102
Mailing address
9 BALMORAL DR STE A, POPLARVILLE, MS 39470-3344
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4787
MS
Other
Enumeration date
07/19/2011
Last updated
09/15/2020
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