Individual
GAVIN SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
339 E MAPLE ST, NORTH CANTON, OH 44720-2593
(330) 498-8200
Mailing address
52 N MAIN ST, UTICA, OH 43080-7704
(740) 641-7761
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA011265
OH
Other
Enumeration date
03/22/2018
Last updated
03/22/2018
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