Individual
MS. ANITA M SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-3071
Mailing address
287 DEMAR AVE, SHOREVIEW, MN 55126-2354
(651) 490-3409
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
744
ND
Other
Enumeration date
03/16/2007
Last updated
07/08/2007
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