Individual
SHANE THOMAS JOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
256 N MAIN ST, MANCHESTER, CT 06042-2004
(860) 696-2300
Mailing address
48 PINEWOOD TRL, DEEP RIVER, CT 06417-1609
(860) 526-1320
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5749
CT
Other
Enumeration date
07/06/2022
Last updated
08/24/2022
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