Individual
MRS. SHANON IMENA HARDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CP
Contact information
Practice address
1900 E MAIN ST, DANVILLE, IL 61832-5100
(217) 554-3000
Mailing address
6007 SNOWY EGRET LN, GREENACRES, FL 33415-1528
(510) 847-7447
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
PRO167
FL
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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